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UNIVERSITY  OF  CALIFORNIA^  SAN  DIEGO 


3  1822  02686  0247 


WAR-TIME  NERVES 
HERBERT  J.  HALL 


»«• 


UNIVERSITY  OF  CALIFORNIA    SAN  DIEGO 


3  1822  02686  0247 


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WAR-TIME  NERVES 

THE   UNTROUBLED   MIND 

MOONRISE  — A  BOOK  OF  POEMS 


WAR-TIME  NERVES 


WAR-TIME  NERVES 


BY 


HERBERT  J.  HALL,  M.D. 


BOSTON  AND  NEW  YORK 
HOUGHTON  MIFFLIN  COMPANY 

QTbt  3Riber0itie  l^vtae  CambriDgf 
1918 


COPYRIGHT,    I91S,    BY    HERBERT  J.   HALL 
ALL    RIGHTS   RESERVED 

Published  September  iqi8 


Master  of  Masters, 
O  maker  of  heroes, 
Thunder  the  brave, 
Irresistible  message  :- 
'Life  is  worth  Living 
Through  every  grain  of  it. 
From  the  foundations 
To  the  last  edge 
Of  the  cornerstone,  death.'' 

W.  E.  HENLEY 


NOTE 

These  papers  made  their  first  appearance  in  the  "Bdlman 
and  are  now  published  in  book  form  with  the  permission 
of  the  editor. 


CONTENTS 

I.  War-Time  Nerves     .      .      .      .  i 

II.  A  Change  OF  System       ...  9 

III.  Moods  AND  Obsessions    ...  18 

IV.  Practical  Patience  .      .      .      .27 
V.  Recalled  to  Life      ....  34 

VI.  Waiting 4' 

VII.  Justification 48 

VIII.  The  Middle  Course.      ...  56 

IX.  Medical  Partnership     ...  64 

X.  Truth-Telling  in  Medicine       .  72 

XI.  A  Way  Out 80 

XII.  The  Medicine  of  THE  Spirit       .  92 

XIII.  Symbols 103 

XIV.  Sleep 112 


I 

WAR-TIME  NERVES 

He  whom  a  dream  hath  possessed  knoweth  no  more  of  doubting. 
For  mist  and  the  blowing  of  winds  and  the  mouthing  of  words  he 

scorns; 
Not  the  sinuous  speech  of  schools  he  hears,  but  a  knightly 

shouting, 
And  never  comes  darkness  down,  yet  he  greeteth  a  million 

morns. 

He  whom  a  dream  hath  possessed  knoweth  no  more  of  roaming; 
All  roads  and  the  flowing  of  waves  and  the  speediest  flight  he 

knows, 
But  wherever  his  feet  are  set,  his  soul  is  forever  homing, 
And  going,  he  comes,  and  coming,  he  heareth  a  call  and  goes. 

Shaemas  O  Sheel 

What  is  the  war  doing  to  the  mind  and  heart; 
to  the  nerves  of  the  Nation?  I  can  answer 
only  as  one  obliged  to  stay  at  home  and  who 
looks  out  from  an  obscure  corner  upon  the 
great  world  conflict.  It  is  possible  that  such  a 
viewpoint  may  have  its  own  special  value  and 
interest. 

A  boy  of  nineteen  goes  into  aviation  because 
he  likes  it  and  "because  it  does  not  matter  if 
a  few  boys  are  killed  off  in  practice  —  that  will 


WAR-TIME  NERVES 


leave  the  older  men  for  their  larger  work." 
This  is  not  fatalism,  it  is  not  the  discouraged 
cry  of  a  man  tired  of  life,  neither  is  it  patriot- 
ism in  the  narrow  sense.  It  is  good-will,  good 
sportsmanship,  the  new  nerve  of  the  Nation. 
It  is  more  still.  These  boys,  many  of  them  sons 
of  rich  men,  are  accustomed  to  luxury  and 
comfort  —  too  much  accustomed.  They  are 
deliberately  and  in  great  numbers  choosing 
danger,  privation,  and  death  as  something 
better  than  what  they  were  having.  Why? 
Not  entirely  from  love  of  the  game,  we  may  be 
sure,  although  that  element  is  strong. 

The  individual  and  the  war,  or  in  relation 
to  the  war,  offers  a  most  absorbing  study. 
How  do  men  go  into  it  and  why,  and  what  is 
the  reaction  upon  those  who  stay  at  home? 
This  much  is  sure:  those  who  go  and  all  of  us 
who  are  affected  are  simplifying  life,  not  com- 
plicating it  any  more.  We  shall  all  know  our- 
selves better,  we  shall  understand  better  why 
we  do  anything,  and  we  are  more  likely  to  be 
direct  and  effective  in  every  way. 


WAR-TIME  NERVES 


When  a  man  denies  himself  all  he  has  held 
valuable  and  presents  himself  naked,  so  to 
speak,  before  the  great  god  of  war,  more  than 
he  probably  knows  has  happened.  I  am  not 
going  to  idealize  and  imagine  character  changes 
which  are  not  true.  Every  man  will  approach 
his  service  from  a  different  angle  and  the  per- 
sonal result  will  be  different  in  each  individual. 
But  with  the  eyes  of  the  physician  I  have  seen 
into  the  lives  of  a  number  of  men  who  have 
enlisted  or  who  have  been  drafted,  who  have 
come  back  from  service  or  who  are  waiting 
to  go.  1  have  also  studied  somewhat  the  lives 
of  people  who  stay  at  home.  It  is  all,  or  mostly 
all,  good;  and  the  greatest  change  is  in  simpli- 
fication and  a  new  idealism.  We  no  longer  need 
so  many  things  to  make  us  happy.  There  is 
in  the  air  a  sense  of  relief  even  in  the  face  of 
dread  and  danger.  But  simplification  in  itself 
would  not  be  so  valuable  if  it  did  not  leave 
room  for  and  make  possible  certain  great 
positive  virtues. 

War,  even  to  those  at  home,  is  such  an  all- 


WAR-TIME  NERVES 


pervading,  penetrating  matter.  It  gets  into 
the  most  sluggish  blood,  it  activates  the  most 
torpid  brain,  it  makes  men  alive,  it  makes 
them  think.  They  think  not  in  petty  detail 
any  more,  but  in  large  directness.  They  think 
of  war,  yes,  and  how  to  win  it ;  but  they  think 
also  of  life.  When  life  is  so  cheap  it  somehow 
becomes  more  interesting,  demands  explana- 
tions and  understandings  which  we  have  been 
too  indolent  or  too  confused  to  make. 

I  am  not  forgetting  my  medical  viewpoint, 
but  medicine  is  enlarging  its  borders.  Medical 
men  are  permitted  to  think  of  vital  things  now- 
adays, for  it  has  become  evident  that  matters 
of  philosophy  and  of  religion  have  their  direct 
influence  upon  the  body.  It  has  also  become 
evident  that  there  is  a  hygiene  of  the  spirit 
quite  as  important  as  that  of  the  body. 

We  do  not  talk  about  it  much  at  home,  the 
men  who  are  going  into  service  do  not  talk 
about  it;  but  out  of  this  great  simplification 
is  coming  a  new  strength  and  directness  of 
religious  belief  —  a  new  vision.   The  boy  who 


WAR-TIME  NERVES 5 

sails  on  a  collier  or  a  destroyer,  who  sees  the 
world  and  its  distant  ports,  who  stands  his 
watch  in  the  early  morning  when  the  sea 
changes  from  black  to  gray  and  from  gray  to 
blue,  is  seeing  and  learning  something  besides 
navigation  and  geography,  is  spying  for  some- 
thing bigger  than  the  periscope  of  the  lurking 
submarine.  He  is  accepting  cold  and  danger, 
he  is  leaving  behind  all  the  absorbing  diversity 
of  city  life  for  a  purpose  greater  even  than  war. 
He  is  coming  face  to  face  with  himself,  and  he 
finds  that  self  alone  and  unsupported  before 
the  great  mystery,  the  mystery  of  life  and 
death.  Shall  we  not  call  it  the  mystery  of 
God?  The  boy  has  his  duties  to  perform,  but 
they  are  simple,  straightforward;  drill  and 
routine  have  made  them  almost  mechanical. 
The  one  thing  that  is  real  is  the  great  mystery. 
"Why  am  1  here?"  he  asks  himself;  "what 
about  the  morning  and  the  evening  with  their 
wonder  of  sky  and  sea?  What  does  it  mean?" 
We  cannot  answer  these  age-old  questions.  The 
boy  alone  with  the  sea  cannot  answer  them; 


WAR-TIME  NERVES 


but  by  the  very  simplification  of  his  Hfe,  by 
the  ehmination  of  all  else,  he  will  be  nearer 
to  an  adequate  answer.  He  will  answer  par- 
tially and  in  his  own  way  by  his  life,  which 
will  be  broader  and  bigger,  by  his  spirit,  which 
will  be  richer  and  more  generous. 

Perhaps  the  boy  will  realize  that  the  creeds 
and  philosophies  are  far  from  sufficient  to 
meet  the  growing  needs  of  his  spirit.  The 
greatness  of  the  questions  will  bring  to  him  a 
sense  of  their  importance.  He  may  see  that 
he  must  make  some  tentative  answer;  that 
he  must  say  in  effect,  "  I  do  not  know.  But 
by  the  very  wonder  and  beauty  of  life  I  know 
that  there  is  something  behind  it,  some  vital 
being  into  whose  hands  I  commend  my  spirit." 
And  then  there  may  come  a  sense  of  nearness 
to  the  God  of  the  sea,  the  God  so  much  greater 
than  battles,  so  much  greater  than  human  life, 
so  much  greater  than  the  roar  of  guns  and  the 
clash  of  angry  steel.  Nearness  and  glad  de- 
pendence, that  is  enough  —  that  is  religion  — 
that  is  the  great  simplification,  the  great  good 


WAR-TIME  NERVES 


experience  that  the  war  may  bring  to  the  indi- 
vidual, to  the  boy  alone  under  the  stars. 

If  something  like  this  conception  comes  to 
the  soldier  and  the  stay-at-home,  we  shall  leave 
behind  us  much  that  has  made  life  cheap  and 
mean  and  purposeless.  There  will  be  a  new 
nervous  health,  a  new  quality  of  manhood  that 
will  be  the  source  of  finer  and  more  beautiful 
life  upon  the  earth. 

I  am  going  to  borrow  now  part  of  Lord 
Dunsany's  preface  to  "The  Last  Book  of 
Wonder"  —  these  are  the  words  of  a  man  who 
has  seen  actual  warfare  and  who  finds  some- 
thing good  in  it:  — 

"  I  do  not  know  where  1  may  be  when  this 
preface  is  read.  As  I  write  it  in  August,  1916, 
I  am  at  Ebrington  Barracks,  Londonderry, 
recovering  from  a  slight  wound.  But  it  does 
not  matter  greatly  where  1  am;  my  dreams  are 
here  before  you  amongst  the  following  pages; 
and  writing  in  a  day  when  life  is  cheap,  dreams 
seem  to  me  all  the  dearer,  the  only  things  that 
survive. 


8 WAR-TIME  NERVES 

"Just  now  the  civilization  of  Europe  seems 
almost  to  have  ceased,  and  nothing  seems  to 
grow  in  her  torn  fields  but  death,  yet  this  is 
only  for  a  while  and  dreams  will  come  back 
again  and  bloom  as  of  old,  all  the  more  ra- 
diantly for  this  terrible  ploughing,  as  the 
flowers  will  bloom  again  where  the  trenches 
are  and  the  primroses  shelter  in  shell  holes  for 
many  seasons,  when  weeping  Liberty  has  come 
home  to  Flanders. 

"And  now  I  will  write  nothing  further  about 
war,  but  offer  you  these  books  of  dreams  from 
Europe  as  one  throws  things  of  value,  if  only 
to  one's  self,  at  the  last  moment  out  of  a 
burning  house." 


II 

A  CHANGE  OF  SYSTEM 

"Sir,"  I  said  one  evening  to  Doctor  Sangrado,  "I  call  Heaven 
to  witness  on  the  spot,  that  I  have  never  saved  a  patient,  one 
would  think  they  died  out  of  spite."  .  .  .  "If  you  will  take  a 
hint,  sir,"  replied  I,  "we  had  better  change  our  system." 

Gil  Bias 

The  war  holds  tremendous  possibilities  for 
the  men  and  women  who  are  available  for  serv- 
ice or  who  can  work  at  home  in  some  useful 
capacity.  I  want  to  say  a  word,  not  so  much 
for  those  who  are  actually  sick  and  disabled, 
as  for  those  who  for  some  more  or  less  obscure 
reason  cannot  keep  up  with  the  procession  of 
life.  In  these  days  of  accomplishment  there 
is  a  sharpened  and  painful  contrast  between 
the  active  and  the  passive,  the  effective  and 
the  ineffective.  The  so-called  nervous  invalid 
or  the  constitutionally  feeble  find  that  the  war, 
far  from  simplifying,  actually  complicates  ex- 
istence. They  cannot  understand  why  they 
are  unequal  to  the  emergency. 


10 WAR-TIME  NERVES 

The  medical  department  is  weeding  out  of 
the  service  man  after  man  who  is  apparently 
well,  but  who,  according  to  test  and  in  the 
light  of  previous  personal  history,  does  not 
measure  quite  up  to  the  physical  or  nervous 
standard.  I  know  a  young  woman  who  wants 
to  go  abroad  to  work  among  the  poor  and  the 
refugees.  She  has  spirit  enough,  a  wise  head 
and  a  warm  heart,  but  she  lacks  physical  and 
nervous  stamina.  She  ought  rather  to  stay  at 
home  under  medical  treatment  until  her  body 
is  the  best  that  it  can  be.  She  will  surely  find 
some  smaller  but  useful  work  to  do  here.  Shall 
we  call  her  a  failure;  shall  she  call  herself  a  fail- 
ure? Her  situation  is  typical  of  hundreds  who 
are  failing  in  the  ordinary  sense  of  large  ac- 
complishment. 

Unquestionably  it  is  the  business  of  such 
people  to  use  every  known  means  for  full  recov- 
ery. They  will  find  the  medical  profession 
ready  and  eager  to  help  them.  But  medicine 
has  its  great  limitations;  often  enough  it  is 
impossible  to  restore  full  power.    Then  we 


A  CHANGE  OF  SYSTEM  ii 

must  not  depend  upon  medical  treatment  of 
the  usual  sort.  When  drugs  and  surgery,  rest 
and  hygiene,  have  done  their  utmost  and  have 
failed,  it  is  time  for  a  change  of  system,  it  is 
time  for  the  cure  of  readjustment  and  of  new 
understanding. 

As  a  physician  I  have  had  my  share  of  diflfi- 
culty  with  physical  defects  and  deficiencies, 
and  with  those  nameless  conditions  of  the 
body  which  defy  medical  aid  for  years.  But 
I  am  optimistic  because  I  know  that  a  very 
real  cure  is  almost  always  possible  even  though 
some  of  the  physical  limitations  remain.  By 
this  cure  I  mean  a  readjustment  of  life;  an 
adaptation  to  limitations  which  brings  balance 
and  the  greatest  possible  degree  of  physical 
efficiency.  I  say  to  my  discouraged  and  doubt- 
ful patient,  "  Success  is  not  measured  by  what 
you  accomplish,  but  by  what  you  are."  If 
you  are  the  brave,  generous  soul  you  ought 
to  be,  accomplishment  is  a  secondary  matter; 
it  may  be  expressed  in  terms  of  character  and 
of  social  relationship  as  well  as  in  terms  of 


12 WAR-TIME  NERVES 

work.  Without  character  behind  it,  even  work 
is  barren  and  will  ultimately  fail.  With  char- 
acter, material  accomplishment  will  inevitably 
follow  as  far  as  strength  will  allow.  In  any 
event,  the  value  will  be  there;  you  yourself 
are  part  of  the  world's  treasure.  The  success- 
ful man,  the  essentially  well  man,  is  the  one  who 
has  done  the  best  he  can  with  his  equipment. 
It  is  never  wise  or  fair  to  compare  the  work 
of  individuals,  for  we  can  rarely,  if  ever,  know 
just  what  material  there  was  to  start  with  — 
to  work  with.  Yet  a  great  deal  of  discontent 
and  unhappiness  come  from  such  comparisons. 
The  girl  who  cannot  go  to  France  is  likely  to  be 
unhappy,  and  so,  nervously  as  well  as  physi- 
cally ill,  if  she  does  not  see  that  here  in  America 
the  loyalty  and  patience  and  courage  for  which 
she  stands  may  have  their  immense  value,  may 
help  win  the  war  really  —  for  there  are  plenty 
of  people  to  accomplish  the  actual  service  if 
they  are  backed  by  the  character  and  the  en- 
thusiasm, the  whole-hearted  support,  of  those 
who  stay  at  home. 


A  CHANGE  OF  SYSTEM  13 

Such  a  cure  is,  of  course,  not  so  easy  as  it 
sounds.  The  sense  of  failure  is  a  heavy  weight 
not  to  be  shaken  off  and  disposed  of  with  a  few 
fine  phrases.  Yet  there  is  a  cure  for  apparent 
failure.  It  is  the  realization  of  the  fact  that 
many,  many  times  there  has  really  been  no 
actual  failure,  but  only  an  inability  to  reach 
preconceived  ideals.  There  is  no  comfort  here 
for  the  insincere,  for  the  essentially  ineffective. 
To  do  their  best  with  what  they  have  to  work 
with  is  the  business  of  brave  souls  struggling 
against  odds  in  a  stern  and  darkened  world. 
But  since  there  is  no  absolute  standard  of 
accomplishment,  but  only  a  requirement  of 
quality,  there  need  be  no  despair  in  the  hearts 
of  those  who  are  ill  or  poorly  endowed. 

Here,  then,  is  a  kind  of  medicine,  a  new  sys- 
tem, that  does  not  pretend  to  cure  what  can- 
not be  cured,  but  which  turns  failure  into  suc- 
cess and  apparent  defeat  into  victory.  We 
must  not  neglect  the  body;  there  are  reme- 
dies to  cure  many  of  its  ills.  But  when  these 
remedies  fail  there  is  a  medicine  of  the  spirit  — 


14 WAR-TIME  NERVES 

more  potent,  more  desperately  needed  than 
any  salt  or  tincture  known  to  man. 

When  a  man  is  sick,  unable  to  meet  the 
ordinary  requirements  of  life,  and  yet  has  no 
evident  or  organic  physical  illness,  we  say  he 
has  nervous  prostration.  We  are  apt  to  shrug 
our  shoulders  when  we  speak  of  this  affliction 
because  we  associate  it  with  certain  feeble  and 
fussy  women  who  have  been  known  on  occa- 
sion to  pick  up  their  skirts  and  run  as  fast  as 
any  one.  More  often  than  not,  such  a  judg- 
ment is  unjust,  wholly  unfair  to  the  idler  who 
might  perhaps  for  a  short  spurt  do  a  lot  of  hard 
work,  but  who  would  soon  enough  give  out  and 
go  down  in  a  heap. 

There  are  diseases  the  doctors  do  not  or 
cannot  name;  not  dangerous  to  life,  perhaps, 
but  interfering  with  the  proper  working  of  the 
body.  There  are  partly  understood  unbalances 
and  disturbances  which  were  once  called  fanci- 
ful or  imaginative,  but  which  now  are  known 
to  be  real  and  out  of  the  patient's  control.  We 
have  literally  no  right  to  say  that  a  man  is 


A  CHANGE  OF  SYSTEM  15 

making  or  pretending  feebleness  until  every 
possible  means  of  restoration  has  been  tried, 
until  every  investigation  has  been  made;  and 
then,  half  the  time,  we  shall  be  wrong  if  we 
blame  him  for  his  illness. 

As  the  years  go  by,  medical  men  are  learn- 
ing better  how  to  deal  with  these  poorly  de- 
fined illnesses.  They  are  learning  that  one 
weak  organ  affects  all  the  others  and  may 
interfere  even  with  the  proper  working  of 
the  mind  itself.  They  are  learning  that  poor 
nourishment,  with  feeble  muscles  and  badly 
poised  body,  may  affect  the  proper  action  of 
even  normal  organs.  They  are  learning  that 
fear  and  misconception,  the  effort  of  the  mind 
to  protect  itself  against  real  or  fancied  harm, 
may  produce  states  of  great  exhaustion.  And 
they  are  finding  ways  to  remedy  these  defects. 

Of  course,  there  are  a  few  nervous  individ- 
uals who  "enjoy  poor  health."  They  should 
be  criticized  and  ridiculed,  urged  and  com- 
manded, re-educated,  until  they  reform.  There 
is  no  excuse  for  the  real  idler.   In  my  observa- 


i6 WAR-TIME  NERVES 

tion,  however,  the  professional  invalids  are 
very  few  —  an  almost  negligible  number,  es- 
pecially in  these  war-times  when  the  spirit  of 
work  and  service  is  in  the  air.  We  must  be 
very  slow  and  careful  in  our  judgment  lest 
we  do  a  serious  harm. 

Perhaps  the  hardest  part  of  a  nervous  illness 
is  the  almost  inevitable  misunderstanding. 
Not  only  is  the  patient  looked  upon  with 
suspicion,  but  he  suspects  himself  of  being  a 
shirker.  If  he  is  not  considered  a  fraud  and 
made  the  subject  of  ridicule,  he  is  too  much 
pitied;  too  much  pampered,  and  so,  spoiled. 
Perhaps  somewhere  there  is  a  nervous  invalid 
who  is  fully  understood  and  fairly  managed. 
It  would  be  a  pleasure  to  find  him. 

The  reason  for  these  unhappy  misunder- 
standings is  not  far  to  seek.  What  we  call 
nervous  prostration  seems  to  involve  the  per- 
sonality. The  patient  is  depressed;  there  are 
times  when  he  sees  no  light  in  the  sun  and 
no  beauty  in  the  moon.  He  is  querulous  and 
fault-finding,  so  gains  a  bad  reputation.    Per- 


A  CHANGE  OF  SYSTEM  17 

haps  he  becomes  erratic  and  irresponsible, 
impulsive  and  thoughtless.  All  this  list  of 
bad  qualities,  and  much  more,  may  be  the 
unhappy  burden  of  the  neurasthenic.  Some- 
times we  find  a  nervous  patient  who  is  perfectly 
even  and  sweet-tempered.  I  generally  suspect 
such  a  patient  of  duplicity,  and  I  am  not  sur- 
prised when  he  says  something  behind  my 
back  that  he  would  not  say  openly.  Safety 
and  sanity  lie  somewhere  between  these  ex- 
tremes. 

I  shall  try  in  the  next  chapters  to  suggest 
some  practical  ways  and  means  whereby  the 
unfortunate  victim  of  lowered  vitality  may 
find  his  way  back  to  a  tolerable,  if  not  a  happy, 
life. 


Ill 

MOODS  AND  OBSESSIONS 

For  what  has  he  whose  will  sees  clear 
To  do  with  doubt  and  faith  and  fear, 

Swift  hopes  and  slow  despondencies? 

His  heart  is  equal  with  the  sea's 
And  with  the  sea-wind's,  and  his  ear 

Is  level  to  the  speech  of  these, 
And  his  soul  communes  and  takes  cheer 

With  the  actual  earth's  equalities, 
Air,  light,  and  night,  hills,  winds,  and  streams, 
And  seeks  not  strength  from  strengthless  dreams. 

Swinburne 

We  criticize  the  slothfulness  of  the  nervous 
invalid  and  have  small  patience  with  his  whims 
and  his  erratic  habits.  Is  there  any  excuse  for 
a  grown  man  who  is  afraid  to  go  into  a  room 
full  of  people,  or  who  is  afraid  to  go  out  in  the 
good  sunlight  lest  he  have  a  stroke  of  apoplexy? 
Does  any  one  suppose  that  such  painful  obses- 
sions are  agreeable?  It  is  true  that  after  a 
while  the  observance  of  unnecessary  caution 
and  the  assumption  of  absurd  protective  meas- 
ures do  give  a  strange  relief  to  suffering,  and 
so  may  be  carried  out  selfishly  without  regard 
for  the  comfort  of  others. 


MOODS  AND  OBSESSIONS         19 

We  must  not  proceed  to  call  these  people 
cranks  and  punish  them  with  ridicule,  or 
attempt  to  break  their  wills  and  make  them 
conform  to  the  comfortable  social  traditions. 
Sometimes,  perhaps,  we  can  and  should  do  just 
this;  but  more  often  the  result  is  suffering  and 
rebellion  with  the  substitution  of  worse  habits 
or  the  intensification  of  the  old  conditions. 

I  am  not  referring  now  to  the  testiness  of  the 
selfish  and  the  habit-bound  who  must  manage 
everything  or  make  some  one  pay  the  penalty; 
but  rather  to  those  unhappy  souls  who,  with- 
out wish  to  cause  trouble  to  themselves  or  any 
one  else,  have  become  the  victims  of  obses- 
sions and  superstitions  which  threaten  to 
wreck  all  happiness. 

We  are  beginning  to  realize  that  such  con- 
ditions as  I  have  mentioned,  and  worse,  may 
come  about  in  perfectly  natural  and  inevitable 
ways.  Certainly  it  is  rare  to  find  a  person  who 
does  not  possess  in  some  degree  the  possibili- 
ties of  nervous  trouble,  or  who  can  claim  to 
be  wholly  free  from  the  fads  and  foibles  that 


20 WAR-TIME  NERVES 

we  associate  with  the  nervous  invalid.  We 
have  only  to  examine  our  own  experiences  to 
understand  how  morbid  fears  and  suggestions 
may  arise  and  dominate.  With  a  little  self- 
study  we  shall  realize  that  we  are  all  of  us  full 
of  the  suggestions  and  superstitions  that  are 
the  beginnings  of  fear. 

Now,  fear  has  a  way  of  growing  in  some 
minds.  It  is  like  fire  that  gets  in  between  par- 
titions in  a  house  and  smoulders  away  until 
finally  it  breaks  out  and  is  hard  to  control. 
There  are  a  few  people  who  may  be  subject  to 
all  sorts  of  nervous  shocks,  but  who  never 
suffer  fear  in  any  great  degree.  There  are 
others,  suggestible  or  temporarily  sensitive, 
who  become  easy  prey  to  fear  —  fear  which 
may  smoulder  from  childhood  only  to  break 
out  at  some  remote,  unexpected  time.  Some- 
times we  can  trace  nervousness  and  unfortu- 
nate habits  to  old  or  new  fear  and  the  conscious 
or  unconscious  effort  of  the  victim  to  protect 
himself  from  evil.  Often  no  such  connection 
is  evident,  though  we  suspect  its   existence. 


MOODS  AND  OBSESSIONS         21 

Many  complex  and  mysterious  cases  of  hys- 
teria and  nervous  disease  are  apparently  due 
to  hidden  fear.  Serious  nervous  illness  has 
been  cured  by  the  removal  of  fear  —  by  a 
reasonable  explanation  and  reassurance  — 
even  after  the  original  misconception  has  been 
buried  under  a  host  of  irrelevant  symptoms. 

We  must  not  assume  at  once  that  the  dis- 
covery of  the  cause  of  unreasonable  apprehen- 
sion will  make  relief  easy.  Often  enough  there 
are  accompanying  states  of  mind  which  must 
be  overcome  by  complete  re-education,  and 
conditions  of  the  body  itself  which  must  first 
be  righted. 

It  has  always  seemed  to  me  that  the  attempt 
to  cure  a  nervous  illness  by  elimination  of  a 
single  fear  is  a  futile  business  —  something 
like  catching  a  few  rats  in  a  trap  while  the 
breeding-place  in  the  cellar  goes  without 
attention.  Great  relief  comes,  of  course,  when 
a  dominant  fear  or  anxiety  is  conquered;  but 
there  will  always  be  cause  for  fear  in  the  world. 
The  fearful  and  timid  attitude  of  mind  must 


22 WAR-TIME  NERVES 

be  changed  for  one  of  steadiness  and  courage 
—  a  lifelong  task  for  most  of  us,  but  one  which 
will  amply  repay  all  effort.  Once  beyond  a 
certain  point  and  we  shall  be  affected  only  by 
necessary  and  legitimate  anxieties.  But  until 
that  point  is  reached  we  shall  be  unhappy  and 
perhaps  ill  with  fear. 

In  the  average  case  of  nervous  exhaustion, 
accompanied  by  moods  and  obsessions,  we 
may  rarely  hope  for  permanent  and  complete 
relief  from  physical  or  medical  measures  alone. 
I  am  apt  to  say  to  my  patients  who  ask  relief 
from  obsessive  thoughts  and  from  sleepless 
nights  of  trouble:  "  1  can  do  nothing  until  you 
give  me  a  cleaner,  simpler  background  for  my 
work.  Now  everything  is  confusion  and  prej- 
udice; moreover,  you  are  still  too  near  to  your 
moods  to  see  them  clearly  and  to  meet  them 
fairly,  or  to  ignore  them  successfully." 

Before  there  can  be  anything  beyond  a 
transient  and  unreliable  calmness  and  happi- 
ness, there  must  be  a  purpose  in  life  and  a 
striving  for  fulfillment  that  carries  all  before 


MOODS  AND  OBSESSIONS         23 

it,  that  dominates  to  the  virtual  exclusion  of 
fear.  Primal  purpose  is  a  vague  thing  to  talk 
about  or  to  understand.  Doubtless  it  varies 
from  time  to  time  in  form  and  in  evidence.  It  is 
almost  sure  to  be  confused  with  some  lesser 
purpose.  Perhaps  we  may  find  an  understand- 
ing of  the  greater  through  the  less.  The  fine, 
strong  purpose  and  inspiration  which  we  see  in 
the  loves  of  men  and  of  women  will  serve  well 
for  example.  In  true  love  we  have  a  purpose 
sufficient,  to  overcome  obstacles  for  the  attain- 
ment of  its  desire.  The  obstacles  are  heart- 
rending enough  at  times,  but  they  do  not  de- 
stroy the  affection;  rather  do  they  heighten  it. 
Finally,  the  lover,  if  he  is  of  the  right  sort, 
loves  on  even  if  he  fails  of  his  object  and  is 
denied  forever  the  surrender  and  embrace  of 
his  love.  Deep  as  it  is  beyond  most  other  im- 
pulses and  desires,  love  itself  springs  from  a 
deeper  source,  and  that  source  is  wrapped  up 
in  the  final  significance,  the  final  justification 
of  life. 
We  know  a  primal  purpose  best  by  its  work- 


24 WAR-TIME  NERVES 

ing,  by  the  sense  of  obligation  in  us  which  will 
not  be  satisfied,  but  which  urges  us  on  and  on 
toward  achievement  that  is  worthy  and  fine. 
We  know  it  when  we  realize  that  the  demand 
for  achievement  is  pure  and  unselfish,  seeking 
no  reward.  AH  through  life  this  instinct  finds 
its  way  and  will  not  be  wholly  denied,  though 
we  choke  it  and  stifle  it  and  constantly  sub- 
stitute lesser  and  meaner  motives.  When  the 
lesser  and  meaner  motives  have  predominated, 
then  come  confusion  and  despair.  With  the 
confusion  come,  as  a  matter  of  course,  varying 
moods  of  unhappiness  and  dissatisfaction  with 
life. 

"Yet  still  from  time  to  time,  vague  and  forlorn, 
From  the  soul's  subterranean  depths  upborne 
As  from  an  infinitely  distant  land, 
Come  airs,  and  floating  echoes,  and  convey 
A  melancholy  into  all  our  day." 

Because  we  do  not  or  will  not  uncover  and 
know  that  "buried  life";  because  we  do  not 
recognize  its  manifestation  in  the  confusion 
and  complexity  of  our  experience,  we  are  un- 
happy and  melancholy  "in  all  our  day." 


MOODS  AND  OBSESSIONS         25 

It  is  a  long  way  back  to  the  primitive  sources 
of  strength  and  understanding,  and  the  jour- 
ney must  often  be  accompanied  with  pain  and 
disappointment.  The  way  is  blocked  by  sel- 
fishness, by  fear,  by  mental  and  physical 
weakness;  by  material  obstacles  of  a  thousand 
sorts.  Only  rarely  may  we  know  the  "true, 
original  course."  When  we  do,  we  shall  have 
vision  that  sees  through  all  the  complexities 
of  life.  We  shall  return  to  every-day  matters 
with  a  courage  and  faith  which  are  more  than 
equal  to  the  difficulties.  In  such  an  opening 
of  the  eyes  man  sees  more  than  himself,  more 
than  life  and  its  meaning  —  he  comes  face  to 
face  with  the  Creator  of  life,  he  is  born  again. 
Sickness  and  death  he  will  have,  no  doubt, 
but  they  will  be  properly  placed  and  under- 
stood; they  will  be  part  of  the  divine  plan. 

The  reader  will  understand  now  why  I  am 
impatient  of  moods;  why  I  will  not  treat  them 
as  such.  It  is  necessary  to  clear  life  of  tangling 
details  as  far  as  possible,  that  the  real,  the  true 
instincts  may  have  their  way.   This  simplifi- 


26 WAR-TIME  NERVES 

cation  and  purification  of  life  can  always  be 
accomplished  to  some  extent  if  we  are  patient 
and  desire  it.  When  we  have  known  it  even 
in  a  small  degree,  there  will  be  a  transforma- 
tion in  our  moods  and  even  in  the  fatigue  and 
nervous  exhaustion  which  are  born  of  worry 
and  fear.  Individuals  will  differ  widely  in  their 
interpretation  and  expression  of  life,  but  there 
will  be  a  common  seriousness  and  purpose 
which  will  be  of  the  utmost  service  both  to  the 
physician  and  his  patient  in  their  task  of  re- 
storing health  and  happiness. 


IV 

PRACTICAL  PATIENCE 

Teach  me  your  mood,  Oh  patient  stars 
That  chmb  each  niglit  the  ancient  sky. 

Emerson 

Suppose  you  are  physically  or  nervously  dis- 
abled; that  you  tire  easily;  that  you  are  full  of 
doubts  and  fears.  You  are  irritable,  depressed, 
generally  ineffective  and  unhappy.  What  can 
be  done  about  it?  Leaving  out  of  the  question 
for  the  time  being  any  idea  of  immediate  re- 
covery, what  course  can  you  pursue? 

My  first  word  of  advice  is  this:  pitch  your 
life  to  a  low  key.  There  is  nothing  more  painful 
and  futile  than  the  attempt  of  a  singer  to  sing 
higher  or  lower  than  his  compass.  Keep  down 
within  your  own  limitations  however  humiliat- 
ing they  may  be.  Make  the  few  notes  of  your 
life  ring  true;  give  them  the  best  quality  that 
is  in  you  and  you  have  half  solved  the  problem 
of  a  limited  life. 

As  a  rule  it  does  little  good  to  say  to  the 


28  WAR-TIME  NERVES 

nervous  patient,  "You  must  save  your 
strength,  you  must  be  moderate  in  all  things." 
Neither  is  it  good  advice  to  say,  "  Do  a  little 
more  each  day  until  you  reach  your  limit." 
In  this  way  the  limit  is  reached  too  soon  and 
with  the  limit  comes  collapse.  Progress  for 
the  constitutionally  weak  or  for  the  nervously 
unstrung  must  be  very  gradual  and  often  along 
a  series  of  planes  rather  than  up  a  continuous 
incline.  If  the  nervous  invalid  would  be  con- 
tent to  do  the  same  thing  day  after  day  for  a 
considerable  time  without  increasing;  then 
increase  a  little,  only  to  continue  without  a 
further  advance  for  days  or  weeks,  there  would 
be  fewer  discouraged  and  dejected  people  in 
the  world.  The  ambitious  neurasthenic  com- 
monly begins  his  day  with  all  the  force  he  can 
command.  He  commonly  finds  himself  ex- 
hausted long  before  the  day  is  done.  I  believe 
it  is  usually  best  to  begin  the  effort  of  each 
morning  very  gradually,  slowly  mounting  to 
a  maximum  and  slowly  declining  to  a  close. 
There  are,  no  doubt,  many  exceptions  to  this 


PRACTICAL  PATIENCE  29 

rule;  but  breakfast  in  bed  is  sometimes  good 
strategy,  not  in  the  least  deserving  the  odium 
it  usually  receives  in  this  hustling  generation. 
There  is  much  also  to  be  said  for  frequent 
short  periods  of  rest.  The  fighting  giant  of 
mythological  fame  who  gained  strength  from 
Mother  Earth  every  time  he  was  knocked 
down,  who  rose  refreshed  whenever  he  came 
in  contact  with  the  ground,  may  perhaps  find 
his  modern  counterpart  in  the  man  or  woman 
of  limited  strength  who  is  wise  enough  to  break 
into  sustained  effort  with  frequent  short 
rests. 

it  is  a  fact,  verified  by  many  experiences, 
that,  other  things  being  equal,  the  nervously 
sick  and  the  slowly  convalescent  may  increase 
the  range  of  effectiveness  in  this  gradual  way 
to  a  point  often  far  beyond  expectations. 

When  headway  has  been  lost  and  idleness 
has  become  necessary,  we  may  often  choose  a 
very  simple,  elementary  task  or  activity  — 
preferably  some  light  manual  work  —  and  by 
graded  effort  arrive  at  surprising  attainments. 


30 WAR-TIME  NERVES 

It  happens  a  good  many  times  that  improved 
capacity  for  a  given  kind  of  physical  exertion 
means  a  gain  in  every  way:  improvement  in 
patience,  power  of  sustained  effort,  and  in 
general  ability. 

For  a  good  many  years  I  have  been  using 
hand-weaving  in  my  practice,  as  a  sort  of  scale 
on  which  my  patients  may  climb  back  to  effi- 
ciency when  for  almost  any  reason  efficiency 
has  been  lost.  This  old  craft  has  surprising 
possibilities.  It  requires,  in  a  moderate  degree, 
the  exercise  of  the  faculties  most  apt  to  suffer 
in  nervous  breakdown.  Patience,  steadiness, 
smoothness  of  action,  are  all  developed  by 
hand-weaving.  The  too  impulsive,  the  irri- 
table, find  that  they  cannot  do  good  work 
if  they  indulge  in  their  favorite  weakness. 
The  slow,  the  fussy,  and  the  inept  discover 
that  they  must  learn  facility  and  ease  of  ac- 
tion. Insensibly  the  good,  practical  traits  are 
brought  out  and  trained  by  this  simple  work. 
If  the  weaving  can  be  done  in  company  with 
other  patients,  each  sees  the  others'  faults  and 


PRACTICAL  PATIENCE  31 

so  corrects  his  own.  Weaving  is  a  kind  of  game 
which  almost  any  one  will  play  with  amuse- 
ment and  zest.  But  it  is  much  more  than  a 
game,  it  is  an  actual  training  for  renewed  life. 

It  is  surprising  how  little  a  really  tired 
and  nervously  upset  person  can  do  at  first 
without  exhaustion  and  harm;  and  still  more 
surprising,  in  many  cases  of  great  weakness, 
how  quickly  the  amount  of  work  can  be 
increased  with  benefit. 

Nervous  exhaustion  is  usually  a  complex 
condition  involving  physical  defect  and  men- 
tal difficulties  as  well.  The  patient,  sometimes 
through  fear  of  failure,  through  shame  of  his 
disability,  has  become  unsocial  —  he  dreads 
to  be  with  other  people  and  he  has  become 
sensitized  so  that  noise  and  confusion  are  pain- 
ful and  disconcerting.  If  he  attempts  to  go 
back  to  life  directly  he  fails.  He  may  often 
find  his  way  to  balance  and  poise  through  such 
an  occupation  as  weaving  in  a  sanatorium 
workshop  where  the  social  demands  are  only 
incidental. 


32 WAR-TIME  NERVES 

Indirection  —  that  is  the  key  to  many  a 
cure.  The  direct  attempt  to  gain  a  foothold 
often  fails  miserably.  Argument  repels;  phil- 
osophy and  religion  fail.  So  simple  an  expe- 
dient as  hand-weaving,  guided,  directed,  con- 
trolled by  skilled  teachers,  will  sometimes  win 
the  day.  The  patient  finds  himself  restored 
to  something  like  full  efficiency. 

The  thoughtless  observer  will  say  this  proves 
that  many  nervous  patients  could  acquire 
strength  and  health  if  they  would  only  use 
will  power  in  the  ordinary  affairs  of  life.  As 
a  matter  of  fact,  it  is  very  often  absolutely 
necessary  to  resort  to  some  such  expedient 
as  I  have  mentioned.  The  usual  paths  of  re- 
covery are  blocked  by  fear  and  obsession 
and  because  they  are  so  fully  associated  with 
failure. 

There  is  no  magic,  of  course,  in  hand-weav- 
ing; but  like  any  other  manual  work  it  may  be 
made  to  stand  for  something  larger.  Neither 
is  this  nor  any  other  occupation  likely  to  cure 
an  affliction  which  can  be  reached  only  by 


PRACTICAL  PATIENCE  33 

medicine  or  surgery  of  the  usual  sort.  But  if 
the  hfeless  and  listless,  or  the  ambitious  but 
impotent  patient  can  acquire  a  background  of 
carefully  prescribed  work,  the  chances  of  phys- 
ical or  nervous  recovery  will  be  greatly  im- 
proved. Incidentally,  there  may  be  a  product 
of  real  commercial  value.  In  war-time,  when 
the  world  is  so  poor,  productive  industry  even 
of  the  most  limited  sort  is  not  to  be  despised. 
If  every  handicapped  person  were  set  to  work 
in  some  small  productive  way,  the  material 
results  might  become  an  industrial  asset  of 
inestimable  material  value,  to  say  nothing 
of  the  moral  gain  which  always  comes  with 
accomplishment. 


V 

RECALLED  TO  LIFE 

It  had  not  yet  occurred  to  the  civilized  world  that  it  was 
possible  to  do  without  beauty  in  the  things  which  one  handled 
every  day.  And  that  strict,  natural  union  of  use  and  beauty 
kept  extravagance  out  of  things  made  for  a  definite  purpose. 
The  appropriate  fulfilling  of  the  purpose  was  what  the  craftsman 
aimed  at. 

It  is  useless  to  show  us  feeble  work  merely  because  it  is  hand- 
made. Virtue  never  was  its  own  reward  on  such  dubious  condi- 
tions. 

Arthur  Symons 

For  work  is  not  the  punishment  of  a  Paradise  long  lost 
But  rather  the  only  means  of  ever  attaining  to  it. 

Jose  Santos  Chocano 

"Recalled  to  Life"  is  the  title  of  an  English 
magazine  which  is  published  in  the  interest 
of  the  crippled  soldiers  who  are  being  restored 
to  efficiency  through  the  agency  of  curative 
workshops  and  special  industries.  It  seems 
that  the  war  cripples  are  not  to  be  left  to  degen- 
erate in  idleness,  to  become  a  dead  weight  upon 
the  Nation.  Through  the  medium  of  curative 
workshops  and  re-vocational  schools  the  men 


RECALLED  TO  LIFE 35 

are  to  be  restored  as  far  as  is  possible  to  self- 
respect  and  self-support.  They  will  be  literally 
recalled  to  life,  for  surely  it  is  life  to  work  and 
to  produce,  if  a  man  has  a  ray  of  productive 
possibility  in  him,  it  is  to  be  fostered  and  de- 
veloped by  these  new  schools. 

At  first  thought  it  seems  a  little  hard  to  re- 
quire a  poor  disabled,  discouraged  man  to  be- 
stir himself  when  he  so  well  deserves  the  com- 
fort of  idleness.  But  experience  teaches  that 
idleness  is  not  happiness,  and  that  work,  how- 
ever trivial,  is  almost  essential  to  the  health 
and  well-being  of  the  human  animal. 

Toward  the  end  of  any  illness  that  is  likely 
to  leave  some  permanent  disablement,  there 
comes  a  time  when  the  full  force  of  the  mis- 
fortune strikes  home.  This  is  the  time  when 
idleness  is  most  disastrous.  This  is  the  time 
for  depression  and  foreboding  and  for  the  hope- 
lessness which  unmans.  The  crippled  soldier 
is  very  apt  to  say  to  himself,  "Well,  1  have 
done  my  part.  Now  the  Government  can  take 
care  of  me."     Even  if  there  were  no  moral 


36 WAR-TIME  NERVES 

reason  why  the  man  should  take  care  of  himself 
if  he  can,  there  is  economic  necessity  back  of 
the  new  movement.  It  will  be  simply  impos- 
sible for  any  of  the  nations  at  war  to  support 
the  number  of  men  who  would  require  sup- 
port if  no  effort  were  made  at  rehabilitation. 
So  the  military  authorities  are  training  the 
crippled  soldiers  back  to  usefulness,  recalling 
them  to  life,  lifting  them  from  the  morass  of 
idleness  and  degeneration  into  which  so  many 
of  them  would  sink  if  no  effort  were  made  to 
save  them. 

Of  course,  the  problem  of  rehabilitation  is 
immense.  It  involves  a  literal  re-education  in 
some  instances;  it  means  the  establishment  of 
trade  schools  especially  equipped,  the  creation 
of  a  new  factory  system  or  the  readjustment 
of  the  old  system  to  make  room  for  the  intel- 
ligent but  handicapped  worker.  A  little  read- 
ing of  the  magazine  "Recalled  to  Life,"  or  of 
similar  war  literature,  will  gladden  the  hearts 
of  those  who  care  for  the  fate  of  the  cripple. 
The  Lord   Roberts   Memorial  Workshops  in 


RECALLED  TO  LIFE 37 

England  are  already  on  a  self-supporting  ba- 
sis. These  shops  are  manufactories  in  effect 
—  they  study  the  trade  and  aim  to  supply  the 
market  with  salable  products. 

An  attempt  is  being  made  to  differentiate 
rather  sharply  between  curative  workshops 
and  bedside  occupations  with  their  compara- 
tively trivial  products,  and  the  re-vocational 
system  which  aims  to  put  the  men  back  into 
the  regular  ranks  of  industry.  The  lesser  oc- 
cupations are  intended,  first  of  all,  to  arouse 
the  interest  of  the  discouraged  patient,  to 
train  his  hand  and  eye  back  into  coordinate 
and  useful  lines.  For  this  purpose  all  manner 
of  small  occupations  are  in  use  —  military 
revivals  of  the  ancient  crafts.  The  making  of 
wooden  toys,  basket-weaving,  and  rug-making 
are  among  the  occupations  recommended  for 
our  own  convalescent  hospitals.  These  and 
many  other  occupations  are  now  employed  in 
many  of  the  warring  countries. 

Work  with  the  hands  is  a  definitely  medical 
procedure.    It  has  a  restorative  value  almost 


38 WAR-TIME  NERVES 

on  a  par  with  medicine  and  surgery,  since  it 
restores  confidence,  teaches  patience  and  in- 
genuity, and  encourages  the  patient  to  further 
effort.  While  any  trivial  occupation  will  serve 
some  purpose  in  this  direction,  it  is  exceedingly 
important  that  the  prescribed  work  should  not 
be  too  foolish  or  quite  valueless  in  its  product. 

There  are  very  few  real  craftsmen  left  in  the 
world.  Machinery  and  haste  and  poor  taste 
have  well-nigh  destroyed  the  once  dignified 
and  desirable  creative  field.  The  old-time  care 
and  patience,  the  excellent  design  and  color 
work,  are  rarely  found  to-day.  In  their 
places,  for  the  most  part,  we  see  cheap  imita- 
tions, atrocious  color  and  bad  design.  Now, 
there  is  still  a  place  in  the  world  for  good  design 
and  careful  workmanship.  Is  it  too  much  to 
ask  that  there  should  be  some  discrimination 
in  what  we  ask  the  crippled  soldiers  to  do  when 
they  are  re-training  for  life  and  activity? 

For  the  most  part  the  men  will  make  the 
bedside  occupations  only  a  stepping-stone  to 
the  larger  and  the  standardized  occupations. 


RECALLED  TO  LIFE 39 

But  here  and  there  will  be  a  man  who  cannot 
hope  to  work  in  the  larger  way;  here  and  there 
a  man  in  whom  the  making  of  wooden  toys 
will  waken  some  old  instinct  which  can  be 
developed  into  something  like  the  true  crafts 
spirit.  Perhaps  there  will  grow  out  of  the  war 
crippling  a  guild  of  craftsmen,  silversmiths, 
leather-workers,  tapestry-weavers,  designers. 

This  article  is  really  a  plea  for  good  instuc- 
tion  while  we  are  about  it;  for  good  models 
and  good  designs  in  the  curative  work  shops. 
There  are  enough  badly  woven  baskets  and 
poorly  tooled  bits  of  leather,  lopsided  pieces 
of  pottery  and  badly  colored  fabrics,  in  the 
world.  Let  those  who  would  assist  the  de- 
spondent soldier  back  to  usefulness  find  some- 
thing really  clever  and  good  for  him  to  do. 
The  field  of  wooden  toy-making  is  one  of  the 
largest  and  best  opportunities.  But  the  toys 
should  be  designed  by  a  Maxfield  Parrish  if 
they  are  to  be  justified.  The  average  Ameri- 
can youth  is  clever  enough  with  his  hands  to 
produce  excellent  results  if  he  is  guided  and 


40 WAR-TIME  NERVES 

directed  by  far-sighted  teachers.  The  teacher 
need  not  be  a  designer.  She  —  for  it  will  usu- 
ally be  a  woman  —  can  bring  to  the  handi- 
capped worker  good  designs,  good  materials, 
and  a  contagious  enthusiasm.  The  rest  will 
be  comparatively  easy. 

It  does  not  take  much  imagination  to  realize 
that  this  principle  of  carefully  directed  handi- 
capped labor  may  be  applied  to  the  vast  field 
of  industrial  accidents.  Every  year  there  are 
thousands  of  workmen  in  our  factories  crip- 
pled for  life  in  the  ordinary  pursuit  of  their  du- 
ties. One  of  the  good  by-products  of  the  great 
war  may  be  an  awakening  to  the  possibili- 
ties of  special  workshops  and  special  training 
for  those  who  are  handicapped  in  peaceful  in- 
dustry. Thousands  of  crippled  workmen  who 
are  now  discarded  as  useless  may  some  day  be 
systematically  rehabilitated,  "recalled  to  life." 
Some  will  go  back  into  their  trades  and  pro- 
fessions and  some,  who  are  more  seriously 
crippled,  may  reestablish  the  beautiful  old 
crafts  for  which  the  world  has  need. 


VI 
WAITING 

From  the  Silence  of  Time,  Time's  Silence  borrow. 
In  the  heart  of  To-day  is  the  word  of  To-morrow. 
The  Builders  of  Joy  are  the  Children  of  Sorrow. 

William  Sharp 

The  power  of  money,  the  miraculous  accom- 
plishments of  science,  our  wonderfully  efficient 
transportation  service,  make  most  of  us  un- 
willing to  wait  for  slow  growth  in  anything. 
We  are  even  in  too  great  a  hurry  to  read.  We 
content  our  busy  selves  with  reviews  and 
digests.  The  unrolling  film  in  the  darkened 
theatre  takes  the  place  of  the  old-time  ro- 
mance. Gone  forever  are  the  days  of  the 
three-volume  novel,  the  "Three  Decker" 
that  Kipling  celebrates  in  beautiful  verse:  — 

"Full  thirty  foot  she  towered  from  water  line  to  rail, 
It  cost  a  watch  to  steer  her,  and  a  week  to  shorten  sail; 
But,  spite  all  modern  notions,  I  found  her  first  and  best  — 
The  only  certain  packet  for  the  Island  of  the  Blest." 

Illness,  which  so  often  puts  a  check  upon  swift 
accomplishments,  may  be  cured  hastily  some- 


42 WAR-TIME  NERVES 

times  by  the  use  of  powerful  medicines  or  by 
the  skill  of  the  surgeon,  but  there  remains  a 
long  list  of  disabilities  which  call  for  continued 
patience  and  fortitude.  If  physicians  are  tired 
and  even  disgusted  with  the  impatience  of  their 
patients,  they  are  also  surprised  and  cheered 
by  the  courage  and  endurance  which  now  and 
then  develop  even  among  those  who  have  been 
closely  identified  with  the  hurry  and  bustle  of 
life.  It  has  been  my  lot  in  later  years  to  deal 
almost  exclusively  with  illness  that  cannot  be 
cured  quickly  —  with  "nervous"  illness  that 
tests  the  body  and  soul.  And  I  wish  here  to 
record  my  profound  admiration  for  the  pa- 
tience and  steadiness  which  1  have  seen  day 
after  day  in  those  who  have  suffered,  in  those 
who  deplore  the  swift  passing  of  time,  and 
who  cannot  afford  to  wait  for  relief  and  cure. 
But  1  have  seen  impatience  and  discourage- 
ment, too,  and  1  have  tried  to  understand 
what  makes  the  difference. 

One  great  cause  for  impatience  lies,  of  course, 
in  uncertainty.    If  we  could  only  be  sure  that 


WAITING  43 


we  were  doing  the  right  thing,  that  we  were 
not  making  mistakes,  we  would  be  more  wiUing 
to  wait  for  recovery.  It  is  easier  than  it  used 
to  be  to  get  sound  medical  advice  and  treat- 
ment. The  days  of  the  quack  doctor  are  num- 
bered. An  intelHgent  patient  has  little  diffi- 
culty in  recognizing  the  real  thing  in  medicine. 
The  good  doctor  does  not  veil  his  procedures 
in  mystery.  These  are  days  of  consultations. 
If  the  doctor  in  charge  does  not  understand 
the  nature  of  an  illness  and  the  appropriate 
treatment,  he  seeks  information  from  special 
and  expert  sources.  The  hospital  and  the 
laboratory  clear  up  many  doubts.  The  doctor 
who  pretends  to  know  all  there  is  to  know 
about  illness,  or  the  specialist  who  is  blind  to 
everything  outside  his  own  particular  line,  is, 
or  ought  to  be,  avoided. 

Suppose  we  are  satisfied  that  we  are  taking 
the  right  course.  Who  of  us  is  above  impa- 
tience with  the  long  days  and  nights  that  must 
pass  in  disability?  I  believe  that  one  of  our 
greatest  sources  of  relief  is  found  when  we  real- 


44  WAR-TIME  NERVES 

ize  that  life  is  important  and  significant  even  in 
illness.  Too  often  the  patient  says  to  himself, 
"  I  will  begin  to  live  when  1  am  well."  But  what 
if  that  recovery  is  delayed  and  delayed?  Dis- 
couragement settles  into  despair,  still  further 
putting  off  recovery.  The  various  organs  of  the 
body  do  not  thrive  on  despair.  Neither  do 
they  readily  accept  the  "  grin  and  bear  it"  atti- 
tude which  is  the  next  step  forward. 

When  I  first  tell  a  patient  that  illness  and 
the  long  days  of  enforced  leisure  may  represent 
a  priceless  opportunity,  1  expect  to  be  laughed 
at  or  scorned.  I  know  that  pain  and  bodily 
discomfort  will  break  into  any  such  pro- 
gramme. But  chronic  illness  is  not  all  pain. 
The  man  who  misses  the  opportunities  of  ill- 
ness is  just  as  remiss  as,  perhaps  even  more 
wasteful  than,  one  who  lets  business  opportu- 
nities slip  by  without  using  them.  Moreover, 
the  physician  who  does  not  point  out  the  possi- 
bilities of  leisure  is  as  neglectful  as  one  who  fails 
to  use  an  efficient  remedy. 

It  is  better,  perhaps,  not  to  use  as  a  remedy 


WAITING  45 


the  opportunities  of  leisure.  These  opportun- 
ities are  best  used  in  a  cultural  and  develop- 
mental sense.  If  life  is  worth  living  at  all,  it 
is  worth  living  well.  And  it  may  be  lived  well 
even  in  illness. 

The  call  to  right  living  is  not  the  final  urge. 
The  real  call  is  the  primal  obligation  that 
makes  every  man  do  his  best  wherever  he  may 
be  placed. 

We  hear  a  great  deal  nowadays  of  national 
and  community  obligations,  but  it  all  figures 
down  to  the  individual.  It  is  in  some  deep 
way  supremely  important  that  the  individual 
should  reach  his  highest  development.  This 
individual  development  is  commonly  served 
in  material  accomplishment,  in  the  perfecting 
of  human  relationships,  in  our  human  loves 
and  friendships.  But  the  relationships  which 
involve  character  and  which  develop  character 
are  at  their  best  only  when  they  spring  from 
the  deepest  of  all  sources.  The  deeper  source 
is  very  subtle  and  hard  to  define.  I  do  not 
know  how  to  describe  it.    Grossly,  it  lies  in  a 


46 WAR-TIME  NERVES 

development  of  the  relationship  of  the  indi- 
vidual with  the  infinite  spirit  that  lies  back 
of  all  life. 

In  illness,  in  the  days  and  nights  unoccupied 
with  the  occupations  and  diversions  of  business 
and  social  life,  a  man  may  draw  very  near  to 
the  borders  of  life  —  he  may  look  over  into 
the  infinite  with  eyes  of  the  spirit,  he  may  feel 
with  his  heart  what  his  bodily  eyes  and  his 
brain  do  not  understand. 

The  understanding  of  the  heart  may  be  clear- 
est and  best  in  illness.  We  may  have  to  wait 
long  before  we  understand.  Comprehension 
does  not  come  at  once.  Though  illness  makes 
priceless  experiences  possible,  it  also  clouds 
and  obscures.  The  growth  of  a  closer  relation- 
ship between  the  individual  and  the  being  we 
call  God  is  undoubtedly  the  greatest  of  human 
progressions.  It  overshadows  all  else,  inter- 
prets all  else.  If  health  and  even  human  love 
are  taken  from  us,  the  divine  relationship 
stands  and  is  greater  than  these.  A  man  who 
feels  a  personal  relationship  with  God  knows  a 


WAITING  47 


growing  independence  of  the  vicissitudes  of  life. 
He  needs  life  for  expression,  he  needs  the  home 
and  the  office  and  the  shop  where  he  can  work 
out  his  inspiration  in  terms  of  life.  But  fully 
adequate  expression  may  also  be  found  in  the 
narrow  confines  of  his  room  or  the  still  nar- 
rower limits  of  his  heart. 


VII 
JUSTIFICATION 

Now  the  just  shall  live  by  faith. 

Hebrews  10:38 

Calm  soul  of  all  things,  be  it  mine 
To  know,  amid  the  city's  jar, 
That  there  remains  a  peace  of  Thine 
Man  did  not  make  and  cannot  mar. 

Matthew  Arnold 

In  the  course  of  long  illness  many  a  naturally 
brave  and  patient  soul  questions  the  use  of 
further  effort  and  says  secretly  if  not  openly: 
"Why  should  I  keep  on  trying,  I  shall  always 
be  handicapped?  I  am  a  burden  to  myself 
and  to  my  family."  This  is  a  cry  of  suflFering 
which  we  must  in  some  way  answer.  But  to 
make  answer  we  must  touch  upon  questions 
which  are  not  usually  approached  by  the 
doctor  in  dealing  with  his  patient  —  indeed, 
they  are  commonly  ignored  or  avoided  by  all 
of  us  in  our  relationship  to  life.  We  must  find 
our  way  into  deep,  still  places  of  the  spirit  if 
we  are  to  answer  at  all.  We  cannot  always  say 


JUSTIFICATION 49 

to  the  tortured  mind,  "Just  have  courage,  you 
will  soon  be  better."  The  honest  patient  soon 
has  enough  of  that.  Such  an  answer  does  not 
satisfy;  it  meets  only  the  first  requirements. 
It  is  not  bread  but  a  stone  to  the  man  who 
knows  that  he  can  never  be  wholly  well. 

Men  commonly  justify  themselves  by  the 
needs  of  the  hour,  of  the  day  or  the  year.  They 
live  and  work  because  they  wish  to  obtain 
some  material  end;  because  they  wish  to  gain 
knowledge  and  power,  wealth  and  position; 
because  they  want  to  provide  for  their  families. 
Sometimes,  and  this  is  better,  they  work  for 
the  joy  of  working,  and  for  the  relief  and  satis- 
faction which  come  from  good  deeds  well  done. 

The  dear  delights  of  youth,  with  human  love 
and  the  spur  of  splendid  ambition  —  these  are 
enough  while  they  last.  But  they  do  not  last 
forever.  Disappointment  and  sorrow  cloud  the 
scene;  illness  and  dependence  sap  the  courage, 
and  some  day  comes  the  old  cry  of  suffering 
and  protest  —  "What  is  the  use  of  trying 
any  more?  "   Even  love  may  die  or  fail  to  meet 


50 WAR-TIME  NERVES 

the  long  strain  of  suffering.  What  is  there  to 
live  for;  what  is  left?  "  Faith  in  God  remains." 
We  say  that  perhaps  a  little  hesitatingly  and 
we  are  sometimes  laughed  at  for  our  pains. 
It  happens  that  faith  in  God  may  disappear 
also. 

I  suppose  the  older  generation,  with  a  more 
precise  and  a  better  religious  schooling,  may 
have  had  less  trouble  in  retaining  a  working 
faith.  There  is  something  about  the  high 
tension,  stimulating  life  of  to-day  that  makes 
men  lose  sight  of  the  eternal  verities;  that 
makes  them  put  their  faith  in  material  accom- 
plishment, in  sky-scrapers  and  bridges  and 
tunnels,  in  limited  trains,  in  aeroplanes,  in  guns 
and  ammunition,  in  money  and  in  power  — 
all  good  things  in  their  place,  and  when  they 
are  justified  by  an  understanding  and  a  vision 
which  puts  them  and  keeps  them  in  their  place. 
It  is  when  they  become  all,  and  sufficient  in 
themselves,  that  our  fine  fabric  of  accomplish- 
ment comes  tumbling  down  about  our  heads 
and  earth  becomes  a  desert  place.    How  long 


JUSTIFICATION  51 

shall  we  live  this  way  —  failing  to  see  that  ma- 
terial accomplishment  is  nothing  unless  it  is 
the  expression  of  a  deep  experience  within  us 
which  we  call  faith  in  God?  Perhaps  the  great 
war,  with  its  devastation  of  cities,  with  its  de- 
pendence upon  fire  and  steel,  will  open  our  eyes 
and  make  us  see  our  folly. 

To  the  modern  mind,  untrammeled,  inde- 
pendent as  it  is,  the  phrase  —  faith  in  God  — 
is  altogether  too  vague  and  impractical;  it 
is  hardly  more  than  a  phrase.  The  invalid  can- 
not go  to  church  and  the  well  too  often  do 
not  go.  We  cannot  all  have  the  inspiration  of 
common  worship.  The  old  formulae  —  the  old 
beauty  of  form  and  ritual  —  are  failing  to  hold 
those  who  need  most  the  comfort  and  hope 
that  the  church  can  give.  It  seems  that  each 
generation  must  have  its  conception  of  God 
and  that  modern  materialism,  luxury,  and 
what  we  call  education,  have  not  yet  found 
their  God. 

Some  day  —  soon,  perhaps  —  there  will  come 
shining  through  the  smoke  of  the  cities  a  new 


52 WAR-TIME  NERVES 

religious  understanding  which  will  be  the  old 
understanding,  the  old  faith  made  acceptable 
to  the  modern  mind.  It  may  be  that  the 
ghastliness  of  war,  the  crash  and  ruin  of  the 
great  guns,  is  the  one  experience  that  will 
destroy  complacence  and  hopelessness  to- 
gether. The  sick  and  the  well  may  realize  sud- 
denly the  need  of  a  faith  which  transcends 
all  suffering  and  all  loss. 

The  sun  still  shines  over  the  battle-fields 
and  the  moon  still  throws  her  splendor  upon 
the  treacherous  sea.  In  the  glory  and  loveli- 
ness of  these  changeless  things  man  may  once 
more  have  his  vision  of  God  —  a  vision  that 
will  sustain  him  through  all  trials  and  all 
vicissitudes. 

As  1  have  worked  among  my  patients  and 
have  understood  the  hopelessness  that  comes 
when  there  is  no  vision,  I  have  realized  that 
much  misunderstanding  comes  from  the  failure 
to  see  that  each  of  us  must  create  and  main- 
tain his  own  idea  and  vision  of  God.  Suppose  a 
hundred  people  say  over  together  the  Apos- 


JUSTIFICATION 53 

ties'  Creed  and  that  all  believe  it  literally,  or 
think  they  do;  does  any  one  suppose  that  the 
words  mean  the  same  thing  to  each  of  the  hun- 
dred worshipers?  Some  of  the  number  really 
do  believe  literally  and  are  satisfied,  content; 
but  there  will  be  not  a  few  who  see  only  beau- 
tiful symbols  —  whose  real  meaning,  whose 
reality,  is  far,  far  beyond  the  power  of  the  mind 
to  grasp  or  to  understand.  For  those  who 
cannot  visualize  God,  who  worship  really  only 
the  beauty  of  the  sea  and  sky,  and  who  are 
affected  only  by  these  and  by  the  yearning  of 
their  own  hearts,  there  must  be  suffering  and 
often  a  great  darkness.  They  do  not  under- 
stand; they  are  not  satisfied.  Yet  they  may  be 
nearer  the  truth  than  are  those  who  are  eas- 
ily satisfied.  Human  words,  human  ideas,  can 
scarcely  compass  the  infinite,  and  yet  it  is 
through  the  medium  of  human  words  and  ideas 
that  we  all  must  interpret  and  use  even  the 
divine  teachings  of  Christ. 

We  must  have  the  greatest  sympathy  for 
those  who  are  dissatisfied;  who  are  struggling 


54 WAR-TIME  NERVES 

and  groping  to  find  hope  and  faith.  It  is  fair, 
I  think,  to  comfort  them  and  to  assure  them 
that  they  may  not  be  far  from  the  kingdom 
of  heaven.  Their  faithlessness  may  really  be 
faith  after  all,  and  faith  in  the  best  sense. 

When  there  is  faith,  or  essential  faith,  there 
is  also  obligation.  I  think  we  may  almost  say 
that  unless  there  is  a  sense  of  obligation  there 
is  no  faith.  Somehow,  the  consciousness  of 
divinity,  even  that  which  is  expressed  only  in 
the  infinite  beauty  of  nature,  brings  a  sense  of 
conscience  and  of  obligation  to  live  up  to  the 
ideal.  We  know  instinctively  that  what  is  low 
and  mean,  what  is  hopeless  and  irresponsible, 
is  out  of  keeping,  is  unworthy  of  us  if  we  are 
parts  of  the  great  plan.  And  so  we  proceed, 
intermittently  and  painfully  and  imperfectly, 
to  live  up  to  the  dignity  and  beauty  of  life. 
No  matter  if  we  cannot  quite  explain  why  we 
should  do  this,  we  feel  the  obligation  and  we 
follow  it.  If  such  a  course  leads  us,  as  well  it 
may,  to  a  literal  acceptance  of  the  Christian 
faith  —  well  and  good.    If  it  leaves  us,  in  our 


JUSTIFICATION 55 

own  estimation,  or  in  the  estimation  of  others, 
outside  the  pale  —  still  struggling,  searching 
for  a  faith  which  may  never  quite  conform 
with  what  we  expect,  or  others  expect  for  us  — • 
there  need  be  no  despair.  If  we  are  earnest 
and  true,  we  shall  accept  the  obligation  of  pa- 
tience and  courage  and  right  living;  we  shall 
be  justified  in  a  sense.  We  shall  know  in  our 
hearts  that  there  is  use  in  living  and  in  doing 
the  very  best  that  we  can  in  whatever  circum- 
stances we  may  be  placed. 


VIII 
THE  MIDDLE  COURSE 

Moderation  is  the  silken  string   running  through  the  pearl 
chain  of  all  virtues. 

Bishop  Hall  (1574-1656) 

Any  physician  will  agree  that  much  illness, 
and  especially  nervous  illness,  comes  from  fail- 
ure to  follow  a  moderate  middle  course.  It  is 
true  that  many  of  us  have  no  choice.  Necessity 
demands  overwork.  The  school-teacher  must 
concentrate  on  her  work  or  fail.  The  laborer 
must  pursue  his  own  line  though  it  crushes 
him.  But  we  all  overdo  or  overemphasize 
when  there  is  little  or  no  excuse.  The  exces- 
sive worrier  ruins  his  chance  of  successful  liv- 
ing. The  victim  of  an  unhappy  marriage  makes 
his  plight  the  more  serious  by  dwelling  upon 
his  unhappiness.  The  girl  enamoured  of  ex- 
citement paves  the  way  for  nervous  break- 
down when  she  subordinates  all  else  to  the 
pursuit  of  pleasure.  The  business  or  the  pro- 
fessional man  kills  himself  by  his  failure  to 


THE  MIDDLE  COURSE  57 

take  exercise  and  to  devote  a  considerable  part 
of  his  life  to  fun  or  to  some  hobby  which  would 
change  and  relieve  his  tired  faculties.  The 
housewife  who  is  so  fussy  that  she  wastes  her 
energies  daily  in  a  vain  attempt  to  attain  per- 
fection—  why  does  she  do  it?  She  is  rightly 
scornful  of  her  shiftless  neighbor  who  spends 
the  forenoon  in  negligee  and  her  afternoon  at 
whist;  but  she  fails  to  see  that  there  is  a  middle 
course,  or  knowing  a  better  way,  a  more  rea- 
sonable way,  she  will  not  follow  it. 

Let  us  suppose  a  young  woman  who  has  an 
emotional  nature.  Her  mother  was  a  nervous 
invalid  —  excitable,  uneven,  prone  to  extremes 
of  excitement  or  depression.  The  girl  was 
brought  up  in  an  atmosphere  of  unrest.  She 
was  never  taught  to  apply  herself  persistently 
to  any  task.  She  admits  that  she  is  tired  of  life 
since  it  will  yield  her  no  more  pleasure.  A 
study  of  symptoms  reveals  the  fact  that  certain 
people  excite  her,  any  argument  or  strong  emo- 
tion leaves  her  trembling  and  weak.  She  does 
not  sleep  well.   Her  bodily  functions  are  out  of 


58 WAR-TIME  NERVES 

order.  She  has  had  to  leave  school  and  now 
spends  her  time  in  bed  or  in  flying  from  one 
extreme  of  feeling  to  the  other. 

It  does  no  good  to  scold  such  a  person  and 
to  tell  her  she  must  calm  down  and  acquire 
an  even  middle  course.  Such  an  illness  must 
be  attacked  from  all  possible  points.  The  girl 
must,  of  course,  be  advised  to  tranquilize  her 
life  and  she  must  try  to  do  this.  We  must  do 
what  can  be  done  by  diet  and  medical  treat- 
ment. We  must  build  up  her  physique  by 
exercises,  walks,  out-of-door  living.  We  must 
teach  physical  relaxation.  Whenever  possible, 
the  patient  must  be  taken  out  of  the  old  envi- 
ronment which  has  become  strongly  associ- 
ated with  her  illness. 

Nothing  is  more  unwise  than  to  prescribe 
some  new  form  of  excitement  to  stimulate 
her  already  worn-out  faculties.  Rather  should 
we  find  and  maintain  a  life  of  monotony. 
Complete  physical  rest  is  a  good  enough  start, 
but  it  must  not  be  allowed  to  continue  too 
long  lest  the  patient  become  dependent  upon 


THE  MIDDLE  COURSE  39 

protection.  If  there  were  no  physical  objec- 
tion, I  would,  if  I  could,  find  and  make  prac- 
tical some  simple,  monotonous  work.  Usually 
it  is  impossible  to  force  monotony  and  we 
may  ask  only  a  gradual  progression.  Anything 
which  uses  the  faculties  steadily  and  simply 
will  do.  Reading,  sewing,  embroidering,  will 
serve  for  a  beginning.  The  only  requisite  is 
that  there  be  no  excitement. 

We  might  with  advantage  teach  such  a 
patient  to  think  and  act,  even  to  talk,  slowly 
and  without  emotion.  She  will  rebel  at  first, 
perhaps,  and  will  decide  that  such  a  dull  life 
cannot  be  tolerated.  But  after  a  while  she 
will  experience  the  relief  of  monotony. 

I  suppose  that  people  who  work  for  a  living 
rarely  understand  the  debt  they  owe  to  monot- 
ony. It  is  of  the  greatest  value  —  a  steadying, 
equalizing  force.  Many  and  many  a  flighty, 
emotional  person  is  saved  by  monotony  from 
burning  out  the  precious  nervous  powers. 

Beyond  all  this  we  may  well  attempt  to 
bring  about  a  serious  purpose  in  life.    If  there 


6o WAR-TIME  NERVES 

is  to  be  a  real  cure,  the  efforts  must  be  directed 
toward  some  useful  end  outside  of  self;  not 
perfunctory  service,  though  that  is  better  than 
nothing,  but  service  which  is  the  expression  of 
a  generous  heart.  We  serve  our  own  and  our 
families'  needs  —  well  and  good ;  but  the  serv- 
ice which  helps  more  than  that  goes  outside 
and  finds  ways  of  helping  the  world  of  men. 
Can  such  service  be  commanded?  I  think  so. 
It  may  be  necessary  to  command  it  literally 
at  first.  But  there  is  a  warmth  and  a  gracious- 
ness  in  service  which  is  its  own  reward.  Even 
here  we  must  insist  upon  moderation,  even- 
ness, and  persistence.  If  we  cannot  find  con- 
stant expression  of  the  idea  of  service  we  can 
at  least  keep  alive  the  desire  that  waits  pa- 
tiently for  opportunity. 

It  is  true  that  self  must  be  cultivated  and 
made  good.  We  need  not  be  feverishly  anxious 
for  active  service  if  the  mind  is  being  schooled 
to  self-control,  to  an  even,  reasonable  course. 
If  illness  is  severe  and  disabling,  there  must 
be  no  frantic  effort  to  escape  —  only  a  calm. 


THE  MIDDLE  COURSE  6i 

reasonable  acceptance  which  waits  patiently 
for  strength  and  opportunity.  We  must  un- 
derstand the  difference  between  this  kind  of 
self-consideration  and  sheer  selfishness. 

After  all,  the  best  remedy  for  the  ills  of 
emotion  is  self-forgetfulness.  Never  are  we 
more  truly  ourselves,  more  characteristic  and 
personal,  than  when  we  forget  ourselves  in  the 
service  of  others.  Such  self-forgetfulness  can 
hardly  come  until  we  have  slowed  life  down  to 
a  strong,  even  current  of  thought  and  action. 
The  sudden  blaze  of  generous  enthusiasm  soon 
dies  and  is  gone,  bringing  back  self  and  dark- 
ness. 

Is  there  such  a  thing  as  service  for  selfish 
ends?  I  suppose  so,  but  it  must  be  rare.  It 
will  never  be  found  in  us  if  we  understand  that 
service  is  really  the  finest  expression  of  self. 

I  have  written  all  this  in  defense  of  monot- 
ony, and  yet  I  would  not  have  life  really 
monotonous.  I  do  not  wish  to  advocate  un- 
emotionalism  except  as  a  remedy,  but  I  do 
urge  it  as  a  necessary  balance  for  those  who 


62  WAR-TIME  NERVES  

overdo  emotion.  I  have  said  that  many  a  man 
owes  his  physical  and  nervous  health  to  such 
a  preponderance  of  calm  or  to  the  voluntary 
or  involuntary  acceptance  of  a  middle  course 
in  business  or  profession.  Moderation  must 
become  second  nature  if  we  are  to  be  successful 
in  the  larger  sense.  The  moderate  man  may 
earn  fewer  dollars  and  have  a  smaller  business. 
The  moderate  woman  may  have  a  lesser  social 
success.  But  there  will  probably  be  more  real 
happiness,  longer  life,  and  better  health. 

In  emotion  and  deep  feeling  we  shall  have, 
no  doubt,  the  greatest  joy  of  life;  but  only  if 
we  are  well  enough  to  bear  the  stress,  only  if 
there  is  a  balance  which  keeps  us  from  being 
worn  out.  When  that  balance  is  attained  we 
may  welcome  intense  feeling.  The  man  who  can 
witness  suffering  without  emotion  is  not  to  be 
trusted.  Give  generously  of  tears  and  smiles  and 
hearty  laughter,  but  do  not  forget  the  need 
of  steady,  invincible  purpose.  Balance  life; 
steer  the  middle  course;  do  not  bear  down 
too  hard  on  work  or  play;  find  opportunity 


THE  MIDDLE  COURSE  63 

for  service,  for  self-forgetfulness,  for  serenity, 
and  you  will  be  able  to  meet  emotional  de- 
mands safely  and  well. 

All  this  is  truism.  Not  a  word  that  I  have 
written  in  this  chapter  but  is  known  and  un- 
derstood by  every  one  who  thinks  at  all.  Why 
write  it,  then?  Because  it  needs  to  be  said, 
over  and  over  again,  until  by  sheer  repetition 
it  makes  an  impression  upon  our  own  careless 
and  forgetful  minds. 


IX 

MEDICAL  PARTNERSHIP 

No  man  is  so  foolish,  but  may  give  another  good  counsel 
sometimes;  and  no  man  is  so  wise,  but  may  easily  err,  if  he  will 
take  no  other  counsel  but  his  own.  But  very  few  men  are  wise 
by  their  own  counsel  or  learned  by  their  own  teaching.  For 
he  that  was  only  taught  by  himself,  hath  a  fool  for  a  master. 

Ben  Jonson 

Occasionally  we  see  a  real  partnership  in 
medicine.  Too  often,  the  men  who  might 
be  strengthened  by  cooperation  are  working 
singly,  even  in  competition  and  at  cross- 
purposes. 

I  know  of  one  young  man  who  had  the  good 
fortune  to  acquire  a  large  practice  almost  im- 
mediately after  leaving  the  hospital.  Instead 
of  keeping  it  all  to  himself,  instead  of  degener- 
ating into  a  drudge,  he  invited  a  young  medi- 
cal man  of  his  own  age  to  come  into  partner- 
ship. These  two  men  together  were  able  to 
do  a  great  deal  more  good  medical  work  than 
either  could  have  done  alone,  and  they  gave 
the  community  in  which  they  lived  a  quality 


MEDICAL  PARTNERSHIP         65 

of  service  which  would  have  been  impossible 
without  cooperation.  Naturally  the  second 
man  was  not  very  busy  at  first.  He  attended 
to  the  emergencies  and  saved  his  partner  from 
rushing  about  on  these  sudden  calls  to  the 
detriment  of  his  daily  routine.  The  second 
man  was  able  to  do  a  lot  of  advanced  labora- 
tory work  such  as  had  never  been  done  before 
in  the  town  where  the  two  men  lived.  By 
pooling  their  interests  they  could  afford  special 
appliances,  a  progressive  library,  large  and 
well-equipped  offices. 

In  the  evenings  the  two  men  held  little 
conferences  concerning  their  practice.  They 
worked  independently,  learning  their  own 
lessons,  making  their  own  mistakes,  but  profit- 
ing mutually  by  their  experience. 

I  have  no  doubt  their  patients  gained 
greatly  by  the  arrangement,  and  I  am  sure 
the  young  men  did,  for  among  the  advantages 
they  had  leisure.  Each  was  able  to  make  occa- 
sional trips  to  the  neighboring  city.  They  kept 
up  their  hospital  relationships  and  could  relax 


66 WAR-TIME  NERVES 

at  theater  or  club  without  the  haunting  fear 
that  something  was  going  wrong  at  home  or 
that  some  rival  was  appropriating  the  prac- 
tice. 

Finally,  after  many  years  of  cooperative 
work,  several  partners  having  come  and  gone, 
the  first  man  was  able  to  take  up  a  specialty 
—  a  specialty  enriched  and  broadened  by  all 
this  cooperative  work  in  the  field  of  general 
medicine. 

It  is  common,  though  not  common  enough, 
for  older  men  to  take  young  graduates  into 
partnership.  But  I  wish  the  example  of  these 
younger  associates  might  be  more  generally 
followed.  We  should  then  far  less  often  see 
the  unfortunate  spectacle  of  the  general  prac- 
titioner doing  inferior  work  because  of  over- 
work. We  should  not  see  so  many  good  men 
wearing  out  before  their  time.  And  more  im- 
portant still,  there  would  be  less  reason  for 
the  modern  tendency  toward  the  substitution 
of  the  hospital  for  the  family  doctor. 

I  realize  that  the  hospital  with  its  perfected 


MEDICAL  PARTNERSHIP         67 

equipment,  with  its  association  of  highly 
trained  specialists,  must  occupy  a  position 
of  ever-increasing  importance.  The  hospital 
solves,  and  will  continue  to  solve,  many  a 
knotty  medical  problem  which  would  never 
be  properly  met  by  the  general  practitioner 
working  alone  or  even  by  such  partnerships 
as  I  have  described.  But  we  ought  never  to 
lose  the  general  practitioner.  His  varied  ex- 
perience, his  intimate  knowledge  of  the  patient 
and  the  patient's  home  conditions,  supply  a 
point  of  view  that  the  impersonal  hospital 
group  can  never  attain..  If  the  men  in  general 
medicine  will  only  work  together  they  will 
never  cease  to  justify  themselves. 

As  a  matter  of  fact,  a  large  proportion  of 
the  problems  which  are  presented  to  the  fam- 
ily doctor  are  not  medical  problems  at  all  in 
the  literal  sense,  but  social  and  personal  af- 
fairs, which  need  the  medical  viewpoint,  to  be 
sure,  but  which  need  more  than  that  —  the 
calm  judgment  of  one  who  knows  the  facts 
from  personal  observation.   It  is  quite  possible 


"68 WAR-TIME  NERVES 

to  study  into  the  physical  functions,  the  heart, 
the  liver,  the  kidneys,  and  all,  using  the  most 
intricate  and  perfect  apparatus  without  once 
approaching  the  real  personal  need  of  the 
patient. 

Undoubtedly  there  are  a  large  number  of 
incompetent  general  practitioners  who  are  not 
serving  well  their  communities;  but  there  is  and 
always  will  be  an  immense  field  of  usefulness 
for  the  general  practitioner,  especially  if  he  will 
not  depend  wholly  upon  his  own  personal  ex- 
perience, but  will  use  the  hospitals  and  the 
knowledge  of  his  fellow-workers  whenever  it  is 
possible  to  do  so. 

All  this  leads  up  to  the  idea  of  another  kind 
of  medical  partnership  even  more  important 
—  a  partnership  of  physician  and  patient. 
Too  often  the  patient  goes  to  the  doctor  com- 
plaining of  some  symptom  for  which  he  de- 
mands instant  relief,  but  without  being  willing 
to  take  the  physician  into  his  confidence  at 
all.  No  wonder  there  are  failures.  Not  long  ago 
a  young  woman  appeared  in  a  doctor's  office 


MEDICAL  PARTNERSHIP         69 

stating  that  she  had  consulted  many  other 
physicians,  all  of  first-class  standing,  and  that 
none  of  them  had  done  her  any  good.  She 
complained  of  headache,  indigestion,  and  sleep- 
lessness. The  doctor  went  over  her  history 
carefully  and  made  a  complete  physical  ex- 
amination without  finding  anything  amiss. 
"Now,"  said  he,  "I  do  not  wish  to  pry  un- 
necessarily into  your  private  life,  but  I  must 
know  if  you  are  happy  with  your  husband, 
I  must  know  a  lot  of  things  about  your  rela- 
tionship with  him."  Evidently  there  was 
something  wrong,  for  she  angrily  refused  to 
answer  many  of  his  questions.  "  Well,  madam," 
said  the  doctor,  "  I  am  sorry  that  you  feel 
that  way.  My  interest  is  wholly  professional 
and  impersonal,  but  I  cannot  help  you  at 
all  if  you  are  not  perfectly  frank  with  me." 
So  she  left  him  and  he  did  not  expect  to  see 
her  again.  But  she  came  back  in  a  few  days 
glad  to  confess  to  certain  personal  failures 
which  had  brought  about  misunderstanding 
and  unhappiness.    Her  unwillingness  to  give 


70  WAR-TIME  NERVES 

up  a  selfish  indulgence  had  brought  about  a 
struggle  in  her  own  mind  which  resulted  in 
serious  nervous  strain.  This  woman  became 
a  firm  friend  of  the  impertinently  inquisitive 
doctor  and  did  much  to  increase  his  already 
good  practice.  She  told  him  that  every  other 
doctor  she  had  consulted  gave  her  a  few  pills 
and  a  little  smiling  advice  about  overdoing, 
pocketed  the  fee,  and  bowed  her  politely  out. 

It  is  possible  to  establish  a  real  partnership 
between  doctor  and  patient  —  a  partnership 
founded  on  cooperation,  mutual  confidence, 
and  helpfulness.  Such  a  partnership  will  clear 
up  many  a  puzzling  situation  and  incidentally 
relieve  much  suffering. 

Choose  your  medical  partner  carefully.  He 
must  be  a  man  whom  you  can  trust.  Then 
give  him  your  whole  confidence,  otherwise 
there  can  be  no  true  cooperation  and  the  re- 
sults of  medical  treatment  will  be  unsatis- 
factory. 

There  is  no  excuse  for  the  doctor  who  is 
superficial,  who  is  afraid  to  ask  questions  for 


MEDICAL  PARTNERSHIP         71 

fear  of  being  misunderstood;  and  there  is  no 
excuse  for  the  patient  who  refuses  to  answer. 
It  is  true  that  many  human  problems  are  too 
subtle  and  complex  to  allow  of  easy  solution 
even  when  all  the  facts  are  known.  But  surely 
no  progress  will  be  made  until  the  facts  are 
known.  Tell  what  you  know  of  yourself. 
Frequently  you  will  be  in  the  dark  as  to  the 
true  reasons  for  trouble,  but  you  can  at  least 
state  all  the  facts,  leaving  the  doctor  to  inter- 
pret and  explain.  Do  not  fall  into  the  error  of 
supposing  that  unhappiness  can  have  no  effect 
upon  the  body.  There  are  plenty  of  purely 
physical  ills,  but  they  are  nearly  all  modified 
by  what  you  think  about  them  and  what  you 
think  about  life.  Sometimes  an  illness  is 
wholly  due  to  some  maladjustment  with  life,  a 
fault  which  can  be  easily  corrected.  If  it  can- 
not be  easily  corrected,  the  physician,  if  he 
is  a  wise  man,  can  help  immensely,  for  he  is 
looking  at  the  matter  objectively  and  is  not 
confused  and  blinded  by  your  too  close  rela- 
tionship with  the  problem. 


X 

TRUTH-TELLING  IN  MEDICINE 

One  who  never  turned  his  back  but  marched  breast  forward. 

Never  doubted  clouds  would  break. 
Never   dreamed,    though   right   were    worsted,    wrong   would 

triumph: 
Held  we  fall  to  rise,  are  baffled  to  5ght  better. 
Sleep  to  wake. 

Robert  Browning 

It  makes  all  the  diflFerence  in  the  world  how 
the  truth  is  told.  The  expression  of  the  face, 
the  tone  of  the  voice,  the  choice  of  words,  all 
count.  The  patient  watches  eagerly  to  learn 
his  fate  and  too  often  he  imagines  a  fate  which 
he  does  not  deserve  and  which  will  never  come 
to  him.  On  the  other  hand,  it  is  quite  possi- 
ble for  the  doctor  to  be  so  over-discreet  that 
the  essential  truth  is  not  understood  at  all.  It 
is  certainly  not  good  practice  to  encourage  a 
mortally  sick  man,  week  after  week,  with  a 
false  hope  of  recovery.  A  surgeon  once  told 
me  of  an  illuminating  experience.  The  patient 
was  sent  to  him  for  operation  as  a  last  resort. 


TRUTH-TELLING  IN  MEDICINE    73 

It  was  evident  to  the  doctor  that  operation 
would  do  no  good;  that  it  was,  in  fact,  impos- 
sible. Without  hesitation  he  told  the  patient 
this  and  added  that  he  probably  had  about 
two  months  to  live.  The  man  was  profoundly, 
pathetically  grateful  for  such  a  straight  opin- 
ion. "Well,"  said  he,  "if  I  fight  for  it  I  can 
finish  my  book."  He  had  been  engaged  in  im- 
portant research  work,  much  of  which  would 
have  been  rendered  useless  if  he  had  not  re- 
ceived timely  warning.  For  months  he  might 
have  been  at  work  collecting  his  scattered  data 
if  the  doctors  in  charge  had,  not  been  afraid  to 
tell  him  the  truth. 

He  is  a  wise  physician  who  can  tell  the  truth 
without  spoiling  it  and  his  patient.  In  the 
long-continued  diseases  where  there  are  many 
chances  of  improvement  if  not  of  cure,  we  must 
think  twice  before  we  state  our  opinion.  Man 
is  mortal,  he  will  die  sometime  undoubtedly, 
but  it  is  not  necessary  to  scare  him  to  death 
by  bald  and  unmodified  medical  statements. 
Sometimes  the  physician  himself  is  honestly 


74 WAR-TIME  NERVES 

mistaken  and  tells  for  truth  what  afterward 
proves  to  be  false,  greatly  to  the  patient's  dis- 
tress and  to  his  own  discredit.  In  the  field  of 
heart  and  kidney  affections  especially,  there 
is  a  great  opportunity  for  faulty  truth-telling. 
The  physician  discovers  undeniable  evidence 
of  organic  disease.  He  so  informs  his  patient. 
When  asked  for  a  prognosis  he  tells  what  he 
believes  to  be  the  truth, — that  his  patient  can- 
not live  out  the  year.  Foolish  truth-teller,  un- 
happy patient.  The  doctor  may  have  been  too 
liberal;  the  patient  may  be  dead  in  a  month, 
but  he  may  outlive  his  physician  by  many 
years. 

All  this  brings  us  naturally  enough  to  the 
subject  of  the  so-called  imaginary  ailments. 
The  modern  physician  —  especially  if  he  has 
a  reputation  for  skill  in  nervous  troubles  — 
is  besieged  by  people  who  recount  long  lists 
of  unhappy  symptoms,  but  who  have,  by 
every  reliable  test,  no  disease  at  all.  How  easy 
it  is  to  tell  the  apparent  truth  and  to  say, 
"there  is  nothing  the  matter  with  you";    but 


TRUTH-TELLING  IN  MEDICINE    75 

the  results  of  such  a  dictum  may  be  very  far- 
reaching  and  very  bad.  It  is  true,  of  course, 
that  there  are  imaginary  illnesses  that  can  be 
dispelled  by  such  cheerful  information.  But 
very,  very  often  the  illness  is  real  enough, 
though  the  symptoms  do  not  fit  into  any  rec- 
ognized category.  There  is  usually  something 
the  matter  when  man,  woman,  or  child  gives 
up  work  or  play  and  seeks  medical  aid.  It 
should  be  the  serious  business  of  the  physician 
to  find  out  all  there  is  to  know. 

Functional  disease  of  the  organs  has  been 
recognized  for  a  long  time.  Stomach,  heart, 
any  of  the  vital  organs  become  painful  and 
cease  to  perform  their  functions  properly 
without  being  really  diseased.  Very  lately 
physicians  have  begun  to  understand  subtle 
unbalances  of  such  glands  as  the  thyroid,  the 
supra-renals,  and  the  pituitary  body.  The 
symptoms  of  these  disorders  may  be  simple 
nervousness  and  lack  of  strength.  Only  rest 
and  careful  observation  will  make  clear  these 
conditions  and  permit  of  their  relief.   Much 


76 WAR-TIME  NERVES 

distress  might  be  avoided  if  the  physician  were 
less  inclined  to  make  light  of  the  symptoms; 
if  he  were  to  gain  time,  if  he  needs  it,  by  the 
giving  of  some  simple  tonic  which  could  do  no 
harm,  but  which  would  improve  the  general 
vigor  and  bring  the  patient  back  for  further 
observation  and  treatment.  A  man  who  has 
some  real  trouble,  even  though  it  is  a  slight 
one,  may  be  put  into  a  very  embarrassing  posi- 
tion by  a  premature  statement  of  the  "truth." 
In  these  days  we  see  a  good  many  appar- 
ently miraculous  cures  by  Christian  Science, 
by  New  Thought,  by  prayer,  and  by  other 
unmedical  means.  There  is  no  doubt  at  all 
that  many  painful  illnesses  are  relieved  in  such 
ways.  Physicians  would  be  wiser  to  acknowl- 
edge this  and  to  admit  the  truth.  And  would 
it  not  be  better  still  if  the  Christian  Scientists 
would  also  tell  the  truth,  admitting  that  they 
cannot  cure  organic  disease?  They  would  lose 
nothing  by  such  admission.  They  can  relieve, 
often  do  relieve,  the  troubled,  hopeless  mind, 
and  in  this  way  greatly  improve  even  badly 


TRUTH-TELLING   IN  MEDICINE     77 

diseased  bodies.  But  they  also  do  irreparable 
harm  when  they  claim  to  cure  such  diseases 
as  cancer  or  diphtheria,  thereby  deceiving  the 
patient  and  letting  pass  the  precious  time 
when  an  operation  or  a  serum  injection  might 
save  life. 

There  is  a  very  subtle  and  unfortunate  kind 
of  deception  frequently  indulged  in  by  patient 
and  doctor  alike  —  self-deception;  alas,  it  is 
too  common.  A  man  wants  to  believe  this  or 
that  and  makes  himself  do  so.  I  have  known  a 
doctor  who  knew  that  a  patient  had  tubercu- 
losis, but  who  was  so  anxious  to  have  it  other- 
wise that  he  failed  until  too  late  to  take  the 
necessary  steps  for  cure.  Nearly  all  of  us  con- 
done in  our  patients  habits  of  selfishness  which 
would  be  much  better  frankly  condemned. 
Illness  is  a  little  world  in  itself.  There  is,  per- 
haps, as  much  dishonesty  and  insincerity 
among  invalids  as  among  business  men.  Once 
below  a  certain  level  of  nervous  tone,  the  tend- 
ency is  for  a  man  to  excuse  in  himself  all  kinds 
of  weaknesses.    It  is  easy  for  the  physician  to 


78 WAR-TIME  NERVES 

forgive  this  in  a  patient  and  so  to  lay  the 
foundation  of  continued  self-indulgence.  Great 
wisdom  and  experience  are  necessary  to  dis- 
tinguish between  culpable  weakness  and  weak- 
ness which  cannot  be  helped. 

Physicians  must  learn  to  face  their  medical 
problems  squarely  and  yet  with  an  under- 
standing which  is  human  and  kindly.  They 
must  learn  that  no  absolute  standard  of  be- 
havior can  be  set  for  the  individual;  that 
everything  depends  upon  circumstances.  The 
questions  must  be:  Is  this  patient  doing  the 
best  he  can  with  his  life?  Am  I  doing  the  best 
I  can  for  my  patient? 

Perhaps  we  shall  come  nearer  to  the  truth 
when  patients  and  doctors  revise  their  ideals 
a  little.  The  best  results  are  not  alvv'ays  those 
that  are  nearest  to  physical  perfection.  The 
man  who  finished  his  book  bravely  and  thank- 
fully in  the  short  time  he  had  to  live  came 
nearer  to  success  and  so  to  virtual  cure  than 
many  a  one  who  idles  along  through  a  long 
but  comparatively  useless  life.  He  did  not  fail, 


TRUTH-TELLING  IN  MEDICINE    79 

though  he  died  at  the  time  predicted.  The 
doctor  who  inspires  his  patients  to  brave  and 
eflFective  living  in  spite  of  unavoidable  limita- 
tions may  safely  tell  the  truth  as  he  sees  it. 

There  is  too  much  of  cowardice  in  us;  that 
is  really  the  reason  why  we  cannot  bear  the 
truth.  Every  one  must  face  death.  There  is 
nothing  to  be  afraid  of  in  that.  What  we 
should  fear  is  moral  failure.  No  one  need  con- 
fess to  that  if  he  has  done,  or  if  he  will  finally 
do,  the  best  he  can  with  his  life. 


XI 
•  A  WAY  OUT 

Soon  the  large  mild  stars  of  springtime 

Will  resume  the  ancient  twilight 

And  restore  the  heart  of  earth 

To  unvexed  eternal  poise; 

For  the  great  Will,  calm  and  lonely, 

Can  no  mortal  grief  derange, 

No  lost  memories  perturb; 

And  the  sluices  of  the  morning 

Will  be  ofjened,  and  the  daybreak 

Well  with  bird-calls  and  with  brook-notes, 

Till  there  be  no  more  despair 

In  the  gold  dream  of  the  world. 

Buss  Carman 

A  SANATORIUM  is  a  place  where  people,  who, 
for  any  reason,  are  not  able  to  live  success- 
fully at  home,  may  find  special  conditions 
which  make  health  and  happiness  possible. 
There  is  great  and  increasing  need  of  such  in- 
stitutions. If  they  are  what  they  ought  to  be, 
they  will  do  much  more  than  provide  the  con- 
ditions of  protected  living. 

Too  many  people  fail  in  life  who  might  be 
happy  and  effective  under  special  conditions, 
or  who  might,  with  a  little  judicious  training 


A  WAY  OUT 8i 

and  reconstruction  of  mind  and  body,  be 
made  equal  to  the  most  trying  conditions  any- 
where. A  great  improvement  in  sanatorium 
aim  and  management  has  taken  place  within 
the  past  twenty  years.  The  sanatorium  was 
too  often  a  sort  of  dumping-ground  for  the 
unfit;  a  place  where  poor  souls,  unwelcome  or 
impossible  at  home,  were  literally  incarcerated, 
and  where  the  principal  occupation  was  the 
exchange  of  doleful  life  histories.  All  that  has 
passed  or  is  passing.  The  modern  sanatorium 
is  more  like  a  school  than  a  hospital.  It  does 
sometimes  accommodate  helpless  patients  who 
can  never  be  active  again;  but  it  is  more  often 
a  lively,  busy  center  of  reconstructive  activity. 

There  should  be  no  prejudice  against  the 
sanatorium,  and  no  hesitation  about  securing 
its  advantages  for  those  who  need  its  care. 

A  young  woman  has  broken  down,  as  we 
say,  nervously.  She  has  a  naturally  frail  and 
poorly  functioning  body.  She  has  been  put 
through  the  usual  mill  of  education  without 
any  particular  regard  to  her  limitations.   Being 


82 WAR-TIME  NERVES 

a  young  person  of  spirit,  she  has  kept  up  and 
met  the  requirements  of  school,  social,  and 
family  life  until  she  can  do  so  no  longer.  Her 
complaints  are  manifold.  She  gives  out  with 
indigestion,  irritability,  headache,  backache, 
and  an  unreasonable  fatigue  on  the  slightest 
exertion  —  the  typical  nervous  wreck.  She  is 
sent  to  the  best  physicians,  who  go  over  her 
with  care.  They  find  no  organic  disease.  They 
advise  a  change  of  air,  diet,  a  companion. 
They  assure  the  parents  and  the  girl  that  there 
is  nothing  the  matter  because  they  cannot  find 
any  of  the  usual  signs  of  heart,  kidney,  liver, 
or  brain  disease.  The  patient  is  game;  she  un- 
dertakes to  shake  off  her  nervousness.  Per- 
haps she  succeeds  for  a  while,  but  all  the 
symptoms  return  with  increased  force  because 
she  naturally  enough  pushes  beyond  the  lim- 
its of  her  strength. 

The  girl  accuses  herself;  her  friends  and  her 
family  openly  or  covertly  accuse  her  of  being 
queer  or  a  quitter.  After  a  series  of  plunges 
and  a  like  number   of  collapses   she  settles 


A  WAY  OUT 83 

into  chronic  invalidism.  Moral  and  physical 
strength  are  likely  to  go  by  the  board  together 
because  there  is  nothing  more  discouraging 
than  honest  effort  which  is  rewarded  with  con- 
tinued failure.  Such  a  person  needs  desperately 
to  go  to  a  sanatorium,  not  for  the  continued 
pushing  of  an  inadequate  human  machine, 
probably  not  for  a  further  attempt  to  make  her 
fit  the  conventional  requirements;  but  for  a 
careful  and  leisurely  study  of  her  limitations, 
for  a  considerable  time  of  real  rest  with  mini- 
mum effort  of  any  kind,  and,  finally,  for  a  build- 
ing-up of  force  and  initiative  within  the  natural 
and  inevitable  limitations. 

In  the  sanatorium  it  should  be  possible  to 
discover  just  what  her  failure  means  and  what 
check  she  must  put  upon  her  future  activities. 
More  often  than  not  there  will  be  discovered 
definite  physical  defects  —  a  flabby  muscular 
system  with  a  drooping  body  that  cannot 
function  properly  without  a  great  deal  of 
muscle-building  and  nourishing,  a  long  proc- 
ess of  rcposturing  and  setting-up  of  the  droop- 


84 WAR-TIME  NERVES 

ing  spine  and  prolapsed  internal  organs.  More 
often  than  not  it  will  be  found  that  as  a  result 
of  continued  failure  a  naturally  good  nervous 
apparatus  has  lost  the  art  of  efficient  action. 
Often  enough  also  such  a  patient  is  adrift  in 
her  philosophy  of  life.  The  simple  faith  of  child- 
hood has  gone  and  nothing  really  adequate 
has  taken  its  place.  Here,  then,  is  a  situation 
which  cannot  be  quickly  helped,  but  which  is 
very  far  from  being  beyond  help. 

It  will  not  be  unprofitable  to  follow  this 
typical  nervous  invalid  through  a  modern 
sanatorium  experience.  She  arrives,  we  will 
say,  on  a  gloomy  day.  The  institution,  beauti- 
fully situated  as  it  is  likely  to  be,  has  no  charm 
for  her.  Her  heart  sinks  at  the  sight  of  her 
little  room,  but  she  goes  to  bed  obediently. 
There  is  a  sleepless  night  filled  with  foreboding. 
In  the  morning  comes  the  doctor,  but  he  has 
not  the  professional  air  and  the  usual  long 
string  of  questions.  He  has  provided  himself, 
whenever  that  is  possible,  with  full  informa- 
tion about  the  patient,  so  that  he  will  not  be 


A  WAY  OUT  85 

obliged  at  once  to  go  over  the  ground  trav- 
ersed so  painfully  by  all  the  other  physicians. 
He  does  ask  her  some  questions,  but  they  are 
very  different  from  what  she  expected.  They 
are  friendly,  reassuring  questions.  He  does 
not  attempt  to  make  his  diagnosis  on  the  first 
visit,  he  may  not  even  sound  her  heart  and 
lungs;  all  that  is  likely  to  be  reserved  for  a 
later  date.  He  finds  out  how  badly  she  sleeps, 
how  discouraged  she  is;  but  he  refuses  to  be 
drawn  too  far  into  the  net  of  symptoms.  Yet 
somehow  he  impresses  her  as  knowing  what  he 
is  about.  There  will  probably  be  a  few  days, 
even  a  few  weeks,  in  bed  if  the  exhaustion  is 
profound.  She  will  be  treated  medically  and 
relieved  of  some  of  her  symptoms.  Slowly  the 
antagonism,  the  resentment,  diminishes  under 
the  friendly  ministrations  of  nurses  and  per- 
haps because  of  the  silent  influence  of  certain 
great  trees  that  stand  sturdily  yet  placidly 
between  her  window  and  the  sky.  After  a 
while  come  the  physical  questions  and  the 
physical  tests.   She  discovers  that  her  body  is 


86  WAR-TIME  NERVES 

not  unhealthy,  but  is  badly  hung  and  poised; 
that  the  feeble  muscles  could  not,  in  the  nature 
of  things,  hold  her  up  to  the  physical  require- 
ments; that  it  is  no  wonder  she  is  tired.  These 
muscles  and  relaxed  ligaments,  she  is  told,  can 
be  restored  to  usefulness  if  she  will  be  patient 
and  obedient. 

By  good  fortune  she  is  not  pushed  and  tried 
out  to  the  utmost  —  to  the  breaking  point. 
She  is  held  back  and  given  a  little,  only  a  very 
little,  in  the  way  of  exercise,  or  even  of  treat- 
ment. Ah,  if  they  had  only  known  at  home 
that  weak  muscles  and  nerves  are  not  restored 
by  overuse  and  that  in  such  an  illness  very 
little  use  may  be  overuse.  But  they  could 
not  know.  There  were  too  many  advisers. 
One  would  say,  "exercise";  another,  "rest"; 
and  there  was  no  one  to  prevent  the  harm  of 
violent  extremes. 

After  a  while  the  patient  learns  to  know  the 
doctor  not  as  a  casual  friend,  but  as  a  real  and 
sound  adviser;  a  friend  surely,  though  of  a  new 
sort.   Continued  acquaintance  makes  possible 


A  WAY  OUT  87 


confidences  and  revelations  which  the  special- 
ist in  his  office  could  not  gain.  Even  the  family 
doctor,  if  she  has  been  fortunate  to  know  a  man 
of  that  disappearing  type,  could  not  separate 
and  disassociate  the  patient  from  the  confus- 
ing elements  of  the  home  life  and  so  could  not 
judge  quite  clearly. 

There  is  need  of  clear  vision  now  and  of  wise 
counsel.  It  appears  that  there  have  been  other 
nerve  strains  than  those  on  the  surface.  Mis- 
understandings at  home,  misunderstandings  in 
connection  with  the  awaking  of  sexual  life, 
a  hopeless  love  —  God  knows  what  tangles  of 
heart  and  mind.  A  wreckage  made  possible 
by  the  weak  body  and  by  a  natural  repression 
which  could  not  speak  and  be  understood. 
What  wonder  that  faith  has  died  and  despair 
has  supervened?  A  hard  tangle,  but  not  an 
uncommon  one. 

Fortunate  for  the  girl  if  the  physician  does 
not  attempt  in  a  perfectly  obvious  way  to  set 
her  right;  if  he  does  not  assume  that  all  she 
wants  or  needs  is  a  little  physical   improve- 


WAR-TIME  NERVES 


ment,  the  relief  of  symptoms.  Probably  he 
will  listen  patiently  to  the  story  and  under- 
stand it.  Then  he  will  say,  "We  must  not  go 
into  it  too  deeply  now;  when  you  are  a  little 
farther  on  the  road  to  health  we  will  come 
back  to  it." 

Next  on  the  programme  is  work,  simple  but 
eflFective  work  with  the  hands  —  handicrafts  of 
the  better  sort  which  as  a  rule  do  not  include 
a  lot  of  doubtful  productions  in  hammered 
brass  and  bad  basketry.  Rather  a  careful 
training  in  hand-weaving,  for  example.  Work 
under  competent  instruction  on  looms  that 
are  properly  set  up,  and  with  colors  and  tex- 
tures to  satisfy  the  artistic  sense.  Work,  work, 
what  a  blessing  it  is!  The  rhymthic  beat  of  the 
loom,  the  necessity  for  careful  attention,  drive 
all  complications  out  of  the  mind  for  the  time 
being.  But  the  hard  thoughts,  the  depression, 
the  physical  and  mental  suffering,  will  come 
back.  Usually  the  day  is  split  up  into  many 
short  periods  of  work  and  rest  so  that  there 
is  not  time  for  consecutive  worry  and  not  work 


A  WAY  OUT  89 


enough  to  prove  utterly  exhausting.  The  pa- 
tient is  urged  to  neglect  her  problems  and  to 
slip  gradually  into  the  condition  of  a  machine 
that  works  and  rests  alternately  without  con- 
scious thought.  She  is  told  that  no  harm  can 
come  from  the  neglect  of  her  problems;  that 
later,  when  she  is  better,  they  will  be  more 
easily  solved.  Days  and  days  of  this,  with 
overfeeding  when  that  is  needed,  with  special 
medical  treatment  if  that  is  necessary.  After 
a  while  the  sheer  monotony  of  it  becomes  a 
joy,  an  inexpressible  relief.  The  tired  brain 
and  the  too  busy  nerves  quiet  down  and  the 
final  stage  of  progress  is  reached. 

Out  under  the  trees  in  a  hammock  the  tired 
patient,  who  does  not  try  to  think,  begins  to 
feel  the  sheer  beauty  of  her  surroundings. 
She  could  not  do  this  before;  but  the  improve- 
ment in  her  health,  the  absence  of  the  home 
strain  and  a  growing  belief  in  recovery  finally 
have  their  way  and  she  begins  to  live  simply, 
primitively.  That  is  the  key  to  the  situation 
—  effective  living  in  a  small  and  circumscribed 


90 WAR-TIME  NERVES 

field.  It  is  only  a  question  of  time  when  that 
field  may  be  enlarged;  how  much  enlarged  it  is 
still  too  early  to  know. 

If  religious  faith  is  to  be  a  factor  in  recovery 
there  must  be  no  officious  attempt  to  supply 
it.  The  doctor  may  not  wisely  preach,  but  he 
will  find  out  sooner  or  later  whether  there  is 
need  of  support  and  development  for  such 
germs  of  faith  as  have  not  perished.  The  new 
faith,  if  it  is  to  make  the  cure  complete,  must 
be  one  of  natural  growth.  It  must  grow  out  of 
the  love  of  trees  and  sky,  a  faith  that  gradu- 
ally recognizes  the  spirit  of  God  in  these  great 
evidences  of  His  love.  When  that  recognition 
is  complete,  the  heart  will  supply  what  the 
brain  could  not  compass,  and  gradually,  per- 
haps, the  faith  of  childhood  will  become  under- 
standable and  real.  If  this  happens  there  need 
be  little  anxiety  for  the  future. 

Much  may  remain  to  be  done  along  practical 
lines.  The  field  of  activity  must  be  gradually 
increased  until  the  safe  limits  are  recognized 
and  understood.   The  patient  must  be  taught. 


A  WAY  OUT  91 

if  she  has  not  already  taught  herself,  that  suc- 
cessful living  means  living  within  the  strength, 
but  that  such  limitations  need  not  be  irksome 
or  really  limiting  at  all.  When  it  has  been 
made  clear  that  a  limited  life  well  lived  is  better 
than  a  wider  one  badly  lived,  and  when  the 
habit  of  small  but  successful  living  has  been 
established,  the  mission  of  the  sanatorium  is 
accomplished. 


XII 
THE  MEDICINE  OF  THE  SPIRIT 

With  futile  hands  we  seek  to  gain 

Our  inaccessible  desire, 

Diviner  summits  to  attain, 

With  faith  that  sinks  and  feet  that  tire; 

But  nought  shall  conquer  or  control 

The  heavenward  hunger  of  the  soul. 

The  end,  elusive  and  afar, 

Still  lures  us  with  its  beckoning  flight. 

And  all  our  mortal  moments  are 

A  session  of  the  infinite. 

How  shall  we  reach  the  great  unknown 

Nirvana  of  thy  Lotus-throne? 

Sarojini  Naidu 

The  successful  doctor  is  a  busy  man;  too  busy. 
He  goes  about  among  his  patients  spending  ten 
minutes  here  and  a  half-hour  there,  listening  to 
recitals  of  symptoms,  feeling  of  pulses,  looking 
at  tongues,  listening  to  hearts,  taking  blood 
pressures,  making  keen  and  experienced  obser- 
vations whereby  he  predicts  the  course  of  ill- 
ness and  prescribes  to  the  patient's  physical 
and  mental  relief.  He  finishes  his  day's  work, 
blots  out  the  memory  of  much  that  has  been 


THE  MEDICINE  OF  THE  SPIRIT    93 

said  and  done,  and  goes  to  bed  tired  and  with 
a  vague  dissatisfaction.  He  is  glad  that  he  has 
prevented  the  spread  of  contagion  by  isolation 
and  insistence  on  cleanliness,  or  he  may  realize 
that  he  has  saved  a  life  by  engineering  a  timely 
piece  of  surgery.  Yet  there  is  sure  to  be  in  his 
mind,  if  he  is  a  thoughtful  man,  a  feeling  of 
superficiality  and  futility.  There  comes  before 
him  the  picture  of  the  patients  whom  he  ought 
to  have  helped,  not  only  physically  but  men- 
tally and  spiritually,  but  with  whom  he  has 
totally  failed.  Is  it  not  the  physician's  busi- 
ness to  cure  the  deep  unhappiness  of  life  and 
to  substitute  courage  for  the  distress  and  gloom 
that  accompany  the  sense  of  failure?  He  has 
been  putting  patients  on  their  physical  feet 
whenever  he  could.  He  has  used  all  the  new 
and  better  methods  of  diagnosis  and  treat- 
ment, yet  he  may  have  left  untouched  an 
immense  field  of  human  suffering  which  is,  or 
might  be,  within  his  power  to  relieve. 

Following  a  natural  and  useful  method  of 
procedure,  medicine  is  attempting  to  analyze 


94 WAR-TIME  NERVES 

the  human  mind  in  the  hope  of  detecting  by 
precise  methods  the  failures  and  complications 
of  the  mental  life.  The  classified  questions  and 
answers,  the  kindly  probing  into  matters  of 
suppression,  into  secret  feelings  and  interests 
and  designs,  may  and  often  do  make  possible 
extraordinary  reconstructions  and  improve- 
ments and  much-needed  relief. 

It  has  become  more  and  more  evident  to  me 
that  medical  men  must  be  moralists  and  teach- 
ers if  they  are  to  meet  successfully  some  of 
the  most  distressing  maladies.  There  are  many 
people  who  will  not  go  to  their  clergyman  for 
advice.  I  am  inclined  to  think  that  there  is  a 
great  field  of  mental  illness  which  lies  open  to 
the  physician  only,  and  which  cannot,  as  a 
rule,  be  handled  effectively  by  any  one  else. 
This  may  be  because  the  disappointed  and 
discouraged  patient  usually  conceives  his 
trouble  to  be  partly  or  wholly  physical,  in 
which  case  the  clergyman  would  be  out  of  his 
element;  and  partly  because  the  patient  feels 
that  the  clergyman  has  moral  preconceptions 


THE  MEDICINE  OF  THE  SPIRIT    95 

that  will  surely  bias  him.  When  satisfactory 
moral  teachings  come  from  the  medical  camp, 
the  effect  is  the  more  striking  because  it  is  in  a 
sense  unexpected  and  because  it  takes  intel- 
ligent cognizance  of  the  physical  situation. 
We  know  we  ought  not  to  neglect  our  bodies. 
We  therefore  feel  safer  when  we  take  our 
depressions  and  anxieties  to  the  doctor,  who 
will  first  go  carefully  into  all  the  physical  con- 
ditions and  apply  the  appropriate  remedies. 
Alas,  for  the  nervous  patient  if  the  physician 
goes  no  further  than  the  bodily  symptoms, 
finds  nothing  organically  wrong,  and  prescribes 
a  change  of  air  or  diversion.  It  is  perhaps 
worse  still  if  he  goes  a  little  further  and  de- 
clares that  the  nervousness  and  depression  are 
simply  a  matter  of  temperament  and  may  be 
changed  if  the  patient  is  only  willing.  Such 
a  course  is  fruitful  of  the  most  unfortunate 
misunderstandings  and  discouragements. 

What  is  success?    Who  may  say  that  he 
is  successful  and  not  be  contradicted?     The 


96  WAR-TIME  NERVES 

accumulation  of  money,  the  enjoyment  of 
comparative  health,  the  accomplishment  of 
great  and  good  deeds;  all  these,  in  face  of  the 
ideal  and  in  the  light  of  our  pitiful  mortality, 
seem  small  enough.  My  patient,  who  feels  so 
deeply  a  sense  of  failure,  is  really  in  no  worse 
plight  than  any  man  or  woman  who  looks 
fairly  at  the  limitations  of  life.  We  must  come 
at  last  to  the  world-old  conclusion  that  char- 
acter is  the  important  thing.  We  must  make 
our  patients  understand  that  with  all  their 
physical  limitations  they  may  have  the  great- 
est thing  in  the  world. 

We  can  make  them  feel  that  actual  accom- 
plishment counts  hardly  at  all  in  the  presence 
of  a  spirit  which  is  reborn;  that  such  a  spirit 
will  inevitably  do  its  best  in  the  way  of  ma- 
terial progress,  and  that  v/e  must  accept  such 
physical  limitations  as  may  not  be  cured  with 
a  resignation  which  is  not  darkened  by  de- 
spair. We  may  go  a  step  further  and  make  it 
as  plain  as  we  can  that  in  some  way,  beyond 
our  poor  words  to  express,  the  development 


THE  MEDICINE  OF  THE  SPIRIT    97 

of  character  is  a  wholly  satisfying  experience 
because  it  touches  upon  matters  of  infinite 
reach  and  because  it  connects  in  some  indefin- 
able way  the  human  personality  with  the  divine 
personality.  When  that  connection  is  surely 
made,  failure  ceases  to  exist.  The  sunlight 
glows  with  new  brightness,  and  the  little  amen- 
ities of  life  which  we  have  so  often  considered 
all-important  are  of  real  significance  only  as 
they  minister  to  our  larger  growth. 

Such  medicine  as  this  is  too  seldom  given 
by  the  grave  and  conscientious  medical  men 
who  go  about  their  daily  tasks,  serving  every 
need  but  the  final  great  need,  and  often 
enough  making  people  physically  better  that 
they  may  suffer  spiritually  more.  What  is  there 
about  such  advice  which  need  be  shunned  by 
the  scientific  mind?  We  do  not  hesitate  to 
use  medicines  and  drugs  about  which  we  know 
comparatively  little.  The  modern  serums  and 
vaccines  are  surely  not  wholly  understood. 
I  believe  that  the  medical  adviser  will  be 
absolutely  lost  if  he  attempts  to  preach  any 


98 WAR-TIME  NERVES 

doctrine  or  religion  beyond  which  the  scienti- 
fic mind  may  reasonably  go;  but  such  a  mind 
may  go  much  further  than  it  usually  does,  still 
keeping  within  the  bounds  of  reason  and  under- 
standing if  not  of  actually  proved  fact.  When 
it  is  understood  that  medical  men  may  wisely 
preach  a  new  message  which  is  but  the  old 
message  of  the  spirit  shorn  only  of  sentiment 
and  dogma,  there  will  be  a  new  era  for  the 
healing  art.  The  medical  teacher  will  acquire 
a  spiritual  power  commensurate  with  his  phys- 
ical accomplishments.  He  need  not  usurp  the 
office  of  the  Church,  but  may  easily  send  his 
patients  to  the  pews  with  minds  so  clarified 
and  prepared  that  they  can  understand  and 
use  the  teachings  of  the  pulpit. 

I  realize  that  in  placing  the  life  of  the  spirit 
above  that  of  the  body  I  am  implying  a  kind 
of  impersonality,  a  certain  freedom  from  sel- 
fishness and  self-concern  which  is  beyond  every- 
day experience  and  which  may  well  seem  vi- 
sionary to  men  who  are  fully  occupied  with 
material  things.    I  realize  the  insistence  of  the 


THE  MEDICINE  OF  THE  SPIRIT    99 

material  and  the  actual.  Human  love,  human 
sorrow,  physical  beauty,  the  appeal  of  all  that 
is  true  to  line  and  form,  the  world  of  material 
accomplishment;  all  these  are  intensely  real 
and  important.  Their  call  is  not  to  be  denied, 
nor  is  the  happiness  or  the  sorrow  which  they 
bring  unreal.  But  the  more  I  study  people  and 
things,  the  more  convinced  I  become  that  we 
had  better  make  the  material  world  less  real, 
and  the  spiritual  world  more  real,  if  we  are 
to  live  in  the  largest  sense  and  approach  our 
destiny  untrammeled  and  unafraid.  Out  of  the 
suggestions  of  this  material  world  with  its  in- 
finite charm,  out  of  its  loves  and  enthusiasms, 
we  must  construct  a  spiritual  world  which 
is  largely  impersonal  and  which  is  therefore 
unassailable  and  indestructible.  From  that 
intangible  world  we  call  spiritual  we  may  come 
back  to  the  demands  of  life  with  a  freshness 
and  a  courage  which  see  in  material  things 
hardly  more  than  the  reflections  of  a  larger 
life  beyond.  It  is  only  by  a  kind  of  "other- 
worldliness"  that  we  may  hope  to  give  true 


100  WAR-TIME  NERVES 

values  to  the  material  world.  Approaching 
from  the  impersonal  side  we  are  saved  some- 
thing of  the  poignancy  of  grief,  something  of 
the  finality  of  loss  —  since  these  things  cannot 
too  deeply  hurt  the  spirit  which  reaches  be- 
yond them.  We  can  bear  injustice  and  every 
injury  since  the  spiritual  mind  cannot  suffer 
in  the  material  sense.  But  we  must  make  more 
than  an  approach  to  the  material  life;  we  must 
live  in  fullest  measure.  For  it  is  in  the  fine, 
brave  way  we  live  the  material  life  that  we 
prove  the  value  and  truth  of  the  spiritual. 

To  be  impersonal  in  the  sense  1  mean  is  not 
to  lose  identity  in  a  kind  of  refined  ether,  but 
rather  to  rise  above  material  sensations,  how- 
ever absorbing  they  may  be,  into  an  atmos- 
phere where  we  are  freed  or  partly  freed  from 
the  deadly  insistence  and  finality  of  things. 
So  we  may  enter  an  interpretive  state  in  which 
we  are  freed  from  our  personal  relationships 
and  see  the  world  as  from  a  height.  From  this 
height  we  shall  inevitably  descend  to  do  battle 
with  evil,  to  meet  our  own  personal  responsi- 


THE  MEDICINE  OF  THE  SPIRIT     loi 

bilities,  to  live  and  love  with  a  warmth  and 
fullness  that  would  not  have  been  possible  had 
we  been  wholly  absorbed  in  the  material  — 
submerged  in  the  actual.  Moreover,  I  believe 
that  because  of  such  withdrawal  we  may  be- 
come, do  become,  more  intensely  personal  in 
a  better  sense.  It  is  by  emancipation  from  the 
tyranny  of  facts  that  our  interpretation  of 
facts  becomes  clearer  and  more  individual. 

We  must  not  advise  our  patients  to  forget 
nor  to  forego  the  comforts  and  pleasures  of  life, 
but  rather  to  have  them  and  live  them  more 
fully.  We  must  ask  them  to  go  beyond  these 
fine  material  things  into  a  gracious  aloofness 
which  gives  new  proportions  and  values,  which 
makes  them  live  more  wisely  and  devotedly, 
which  will  make  them  accept  physical  limita- 
tions with  good  heart,  knowing  that  loss  and 
sorrow  are  not  final,  that  they  can  hardly  reach 
beyond  the  material  world. 

Such  a  conception  is  not  wholly  of  the  imagi- 
nation—  a  dream  that  is  pitiful  because  it  offers 
hopes  which  cannot  be  substantiated.   I  believe 


102  WAR-TIME  NERVES 

that  we  may  live  in  such  a  spirit  world  and  be 
unassailably  happy  and  well,  no  matter  what 
may  happen  to  us  materially,  no  matter  what 
losses  we  may  have  to  meet,  or  what  sad  debts 
we  may  have  to  pay,  over  the  counters  of 
reality.  I  even  go  so  far  as  to  think  that  those 
who  are  most  happy  and  who  really  triumph 
over  inevitable  loss  are  already  living  in  the 
spirit  world,  though  they  may  know  it  not. 


XIII 
SYMBOLS 

But  —  a  stirring  thrills  the  air 
Like  to  sounds  of  joyance  there 
That  the  rages 
Of  the  ages 
Shall  be  cancelled,  and  deliverance  offered  from  the  darts  that 

were, 
Consciousness  the  Will  informing,  till  It  fashion  all  things  fair! 

Thomas  Hardy 

The  material  world  is  so  big  and  so  beautiful 
with  such  an  infinity  of  charm  and  delight  we 
need  not  be  blamed  if  at  times  we  consider  it 
final  and  act  accordingly.  But  we  have  to  be 
very  well  and  happy  to  do  this.  The  sea  grows 
dull  and  the  trees  droop  sadly,  the  waves  of 
burnished  grass  in  the  sunlight  soon  lose  their 
luster,  when  illness  or  disappointment  come. 
Love  itself  grows  cold.  The  shadow  of  injus- 
tice and  wrong  darkens  the  world.  However 
hard  we  may  work  to  sustain  what  we  call 
human  life,  that  spark  dies  down  and  goes  out. 
There  is  nothing  fixed  upon  which  we  can 
depend,  since  life  itself  must  finally  depart. 


I04  WAR-TIME  NERVES 

There  is  only  one  remedy  for  this  sense  of 
mutabihty.  We  must  create  a  world  above 
the  world,  or  rather  out  of  it.  As  a  matter  of 
fact,  we  are  continually  creating  this  unseen 
world,  continually  preserving  for  final  life 
the  charm  and  glory  of  material  but  chang- 
ing things.  The  light  upon  the  mountains,  the 
light  upon  the  sea,  have  for  us  a  significance 
far  beyond  their  material  aspects.  The  ma- 
terial world  crumbles  and  disintegrates.  But 
if  we  really  feel  the  beauty  of  nature,  we  shall 
create  for  ourselves  this  upper  world  where 
things  do  not  change.  Our  sorrows  and  dis- 
appointments, our  lack  of  faith,  our  discour- 
agements, make  up,  on  the  other  hand,  a  con- 
trasting world  of  shadow  which  1  like  to  feel 
has  its  significance  and  importance  by  way  of 
contrast,  at  least.  All  this  is  easy  enough.  We 
are  doing  it  all  the  time,  laying  up  for  ourselves 
treasures  in  heaven. 

It  makes  our  material  world  even  more  real 
to  think  that  way  about  it,  to  feel  that  human 
love,  which  seems  so  perfect,  is  but  a  poor 


SYMBOLS  105 


shadow  of  the  real  thing  which  is  struggling  to 
get  through.  Certain  systems  of  religion,  of 
course,  have  it  all  planned,  how  we  shall  pass 
from  this  world  of  material  things  to  the  spirit- 
ual world,  and  a  very  beautiful  planning  it  is, 
perhaps  nearer  to  the  truth  than  we  realize. 
And  yet  here,  more  clearly  than  in  most  other 
fields,  we  are  dealing  with  symbols. 

As  a  young  surgeon  I  used  at  times  to  have 
charge  of  the  accident  room  in  one  of  the  great 
metropolitan  hospitals.  Here  were  brought 
a  long,  sad  train  of  accidents;  many  of  the 
gravest  sort.  Most  of  the  patients,  of  course, 
were  working-men.  They  came  from  the  rail- 
roads and  the  docks  and  they  were  almost  all 
of  them  Roman  Catholics  in  their  religion.  It 
was  our  custom,  whenever  a  serious  accident 
was  brought  in,  to  send  for  a  priest  who  lived 
near  by.  I  have  often  been  privileged  to  stay 
with  the  patient  through  the  final  ministra- 
tions of  the  Church.  Many  times  I  have  seen 
men  groaning  in  agony  grow  quiet  and  smile 
with  a  kind  of  peace,  which  was  then  beyond 


io6  WAR-TIME  NERVES 

my  understanding,  when  the  little  priest  ap- 
peared and  held  up  his  hand.  I  know  now  that 
by  the  symbol  of  the  cross  he  opened  a  door 
into  the  upper  world  where  things  are  perma- 
nent, into  the  world  which  is  bright  with  all 
the  brightness  and  beauty  of  this  world,  but 
which  does  not  fade,  because  it  is  of  the 
spirit. 

Whatever  kind  of  religion  we  may  profess  or 
deny,  such  great  things  happen  to  us  if  we  will 
let  the  material  experiences  of  life  assume  their 
real  value,  their  greatest  value,  which  is  sym- 
bolic. Much  of  this  symbolism  comes  to  us 
unconsciously  or  in  spite  of  skepticism.  It  is, 
after  all,  the  thing  which  makes  life  really  in- 
teresting. The  engineer  who  overcomes  tre- 
mendous odds,  who  builds  his  bridge  where  less 
daring  minds  said  it  could  not  go,  accomplishes 
a  great  deal  more  for  himself  and  for  the  world 
than  the  literal  spanning  of  the  stream,  and  his 
bridge  is  important  for  more  purposes  than 
the  passage  of  traffic.  It  is  symbolic  of  some- 
thing higher  and  finer  than  itself  toward  which 


SYMBOLS  107 


men  are  constantly  striving  and  constantly 
attaining  in  part.  Beautiful  as  is  the  world  of 
material  things,  it  is  the  unattained,  the  half- 
glimpsed  charm  that  gives  zest  to  life,  which 
gives  to  material  things  a  value  far  beyond 
our  appraisal.  I  suppose  it  is  this  partly  appre- 
ciated value  that  keeps  us  going  and  sends 
us  over  at  last  with  good  courage  into  the  un- 
seen world. 

People  of  the  present  day,  active,  busy  peo- 
ple who  have  little  time  for  thinking,  seem  to 
reach  discouragement  and  unhappiness  by  two 
principal  routes:  they  either  fail  in  their  ac- 
complishments, or  else,  having  attained  their 
object,  find  it  inadequate  and  poor.  Some- 
times it  seems  as  though  real  happiness  could 
be  found  only  by  indifference  and  thoughtless- 
ness which  will  not  recognize  defeat  and  which 
simply  refuse  to  consider  the  final  defeat  of 
death. 

We  may  well  ask  these  people  to  accept 
some  form  of  religious  belief  which  will  animate 
their  lives  and  give  them  hope  and  courage 


io8  WAR-TIME  NERVES 

in  a  difficult  world.  But  very  many  will  not, 
cannot  become  religious  in  the  usual  sense. 
It  is  usually  the  mind  which  is  capable  of 
understanding  and  using  symbolism  that  can 
find  in  any  religious  conception  the  relief  and 
comfort  which  it  needs.  For  this  reason  I  plead 
for  symbolism  in  the  common  affairs  of  life 
and  in  the  common  objects  of  life.  Once  we 
begin  to  see  a  significance  beyond  the  actual, 
once  we  discern  in  the  beauty  of  a  tree  or  hill- 
side something  beyond  the  thing  itself,  inde- 
finable, illusive,  yet  infinitely  precious  and 
fine,  we  have  begun  to  be  religious  in  a  very 
real  sense.  We  may  not  be  able  to  accept  one 
doctrine  or  another,  or  any  complete  system  of 
salvation;  but  we  shall  be  opening  our  minds 
to  the  perception  of  the  surrounding  world  of 
spirit  which  interprets  and  glorifies  the  mate- 
rial world  and  which  may  easily,  without  be- 
coming illogical,  make  almost  any  religious  con- 
cept available  for  our  use.  There  are  plenty 
of  men,  good  men,  too,  who  might  become 
deeply  and  consistently  religious  in  the  accept- 


SYMBOLS  109 


ancc  of  some  form  of  belief  if  they  could  ap- 
proach from  the  side  of  logic,  observation,  and 
simple  feeling. 

I  feel  the  greater  interest  in  encouraging  this 
method  of  approach  among  my  patients  be- 
cause it  has  been  my  own  method  and  has 
brought  me  to  a  point  of  appreciation  which 
makes  my  religious  life  a  very  vital  and  com- 
pelling thing.  The  time  came  with  me,  as  I 
suppose  it  does  with  half  the  world,  when  I 
could  no  longer  accept  the  teachings  of  my 
childhood  with  any  kind  of  comfort  or  com- 
plaisance. I  simply  did  not  believe  it.  The 
story  of  the  Christ  and  the  scheme  of  salvation 
meant  little  to  me  because  I  had  developed 
what  I  supposed  was  a  logical  mind  and  was 
dealing  with  facts.  Yet  there  was  always  in 
the  back  of  my  mind  a  deep  longing  for 
some  satisfying  belief  and  a  terrible  sense  of 
finality  in  which  the  idea  of  death  loomed 
large. 

I  did  not  acquire  a  religious  belief  out  of 
hand,  I  did  not  say  I  believe  this  or  1  believe 


no  WAR-TIME  NERVES 

that.  I  could  not  and  be  true  to  what  I  con- 
sidered logic  and  consistency.  1  got  my  reli- 
gion by  gazing  long  and  earnestly  at  the  sea 
and  the  sky,  and  at  all  beautiful  things  that 
came  before  me;  by  looking  with  open  mind 
and  heart  into  the  world  of  nature,  into  the 
deep  woods,  and  into  the  streams;  by  listening 
with  rapt  spirit  to  the  best  of  music;  by  coming 
close  to  the  more  complex  world  of  joy  and 
suffering  in  the  world  of  men.  This  beauti- 
ful world  was  utterly  inexplicable,  impossible, 
unless  it  should  be  symbolic  of  some  greater 
life  and  some  greater  beauty  beyond.  I  gazed 
at  the  blue  and  white  of  the  sea  in  the  sunlight 
and  in  the  drifting  mist  until  I  felt  the  presence 
of  God.  Then  I  could  understand  the  God  of 
the  Bible,  the  God  of  the  Old  Testament,  and 
the  beautiful  symbolism  of  the  Christ  in  the 
New.  I  lost  once  and  for  all  the  feeling  of  lone- 
liness and  despair  that  had  been  so  terribly  a 
part  of  life  before.  I  found  in  symbols  a  sense 
of  greater  life  and  understanding  beyond  the 
realm  of  the  senses.    It  became  possible  for  me 


SYMBOLS  III 


to  worship  and  to  trust  a  God  I  could  neither 
see,  nor  hear,  nor  imagine.  There  can  be  no 
greater  reUef  for  tired  nerves,  for  the  weariness 
of  mental  suffering,  than  just  such  a  conver- 
sion. 


XIV 
SLEEP 

Rose  Aylmer,  whom  these  wakeful  eyes 

May  weep  but  never  see, 

A  night  of  memories  and  sighs 

I  consecrate  to  thee. 

Walter  Savage  Landor 

And  men  grew  afraid  of  sleep  in  Allathurion.  And  they  grew 
worn  and  pale;  some  through  the  want  of  rest,  and  others  from 
fear  of  the  things  they  saw  on  the  cindery  plains  of  Hell. 

Lord  Dunsany 

However  busy  and  restless  the  days  may  be, 
however  driven  and  tormented  the  hours  of 
labor,  the  night  for  most  of  us  is  a  time  of 
quiet,  a  time  dedicated  to  restoration  of  body 
and  mind.  It  is  a  pity  we  do  not  always  use 
the  night  for  this  great  purpose.  How  many 
tired  and  distracted  people  carry  to  their  beds 
the  "cares  that  infest  the  day"!  How  many 
nights  that  should  be  calm  and  serene  are  torn 
and  distressed! 

Sometimes  in  the  stress  of  life  we  may  not 
hope  for  sleep.     Some  great  anxiety,   some 


SLEEP 113 

great  loss,  pain,  or  sorrow,  preclude  sleep  and 
we  must  lie  awake  with  our  unhappy  medi- 
tations. 

All  medical  men  are  besieged  by  patients 
who  beg  for  something  to  make  them  sleep; 
and  all  medical  men  who  are  wise  are  very 
cautious,  very  loath,  to  dispense  the  care- 
dispelling  drugs  which  excuse  our  faulty  living 
and  give  us  sleep.  For  they  know  that  except 
where  there  is  some  great  and  special  need  it 
is  wrong,  or  positively  harmful,  to  induce  sleep 
by  artificial  means.  I  think  I  may  say  truth- 
fully that  with  rare  exceptions  sleep  will  come 
to  "bless  the  tired  eyes"  if  we  live  our  days 
consistently  and  wisely;  if  we  do  not  abuse  the 
privilege  of  life. 

I  find  that  many  of  those  whom  I  am 
tempted  to  drug  to  sleep  are  out  of  tune  with 
life;  are  so  restless  and  turbulent,  or  so  de- 
pressed and  unhappy,  that  sleep  is  impossible. 
I  am  not  thinking  now  of  physical  pain,  that 
is  another  matter;  but  of  the  mental  and  spir- 
itual suffering  which  comes  from  maladjust- 


114  WAR-TIME  NERVES 

ment,  from  rebellion  at  the  deep  unhappiness 
which  is  too  often  our  human  lot. 

The  sleepless  patient  must,  first  of  all,  be 
studied  physically.  We  must  find,  and  correct 
if  we  can,  any  cause  of  physical  restlessness 
or  pain.  We  must  correct  bad  physical  habits 
so  that  the  night  may  be  approached  with  the 
best  possible  bodily  conditions;  then  we  must 
attempt  the  more  subtle  readjustments  of 
mind  and  spirit. 

It  is  easy  enough  to  say  to  the  overworked 
and  sleepless  business  man,  "You  must  leave 
your  cares  behind  you  when  you  go  home." 
But  how  can  he  when  they  are  so  insistent; 
when  fortune  or  wreck  wait  upon  his  judg- 
ment; when  the  worry  and  uncertainty  of  busi- 
ness call  insistently  for  twenty-four  hours  of 
thought  and  judgment?  You  may  even  make 
him  see  that  his  judgment  will  be  better  if  he 
gives  up  to  relaxation  and  diversion  for  a  little 
while.  He  can  rarely  follow  your  advice  unless 
he  acquires  a  superiority,  a  grasp,  which  is 
greater  than  business. 


SLEEP 115 

There  must  be  background  and  justification 
in  life  if  there  is  to  be  tranquillity  and  peace. 
The  tired  men  of  affairs  or  the  weary  and  dis- 
tracted society  women  must  get  behind  the 
details  of  life  —  must  see  life  whole  and  not  in 
restless  parts  —  if  they  are  to  find  restoration 
in  sleep.  We  are  so  much  absorbed  with  the 
material  that  we  get  quite  out  of  touch  with 
the  great  serenity  which  surrounds  us  and  of 
which  we  were  meant  to  be  a  part.  We  put 
the  affairs  of  life  first  and  they  overcome  us. 
We  forget  that  life  and  work,  at  their  best,  are 
but  the  expression  of  something  deeper  and 
finer.  If  we  could  only  get  the  proportion 
right,  if  we  could  work  for  something  besides 
money  and  power,  there  would  be  less  question 
of  sleep. 

How  many  of  us  are  aware  of  the  night; 
how  many  of  us  look  out  of  our  windows  at 
the  moonlight  and  the  trees  with  a  sense  of 
their  beauty,  an  appreciation  which  is  worship? 
How  many  of  us  feel,  behind  the  loveliness 
that  thrills  us,  the  staying,  supporting  spirit 


ii6  WAR-TIME  NERVES 

of  God  —  of  a  God  so  great  and  so  wise  that 
we  may  safely  leave  in  His  hands  all  the  issues 
of  life?  Ah,  if  we  only  could  feel  that  faith 
there  would  be  fewer  sleepless  nights. 

We  sleep  and  dream,  and  the  night  is  hideous 
with  phantoms  and  terrors.  It  is  almost  better 
to  lie  awake.  There  are  theories  about  dreams 
—  ingenious  explanations.  They  express  the 
hidden  desires  and  wishes  —  well  —  perhaps.  I 
do  not  believe  much  in  that,  but  I  know  that 
if  we  treat  our  bodies  well,  if  we  do  not  strain 
and  tax  our  minds  with  needless  worries,  if 
our  lives  are  clean  and  good,  if  they  are  sur- 
rounded and  inspired  by  something  deeper 
than  life,  we  may  dream,  but  the  dreams  will 
not  hurt  us. 

It  seems  that  the  mind  is  what  we  call  sug- 
gestible. We  all  know  that  the  thoughts  we 
take  to  bed  with  us  are  very  apt  to  recur  in  the 
morning  or  in  wakeful  hours.  Most  of  us  have 
had  the  experience  of  waking  as  though  roused 
by  an  alarm  clock  at  some  hour  we  had  chosen 
for  the  beginning  of  a  journey.    If  it  is  so. 


SLEEP 117 

that  the  sleeping  mind  is  sensitive  to  sugges- 
tion, that  it  is  enriched  or  wearied  by  uncon- 
scious thinking,  what  a  field  for  education 
and  development  is  here.  The  poet  or  the 
musician  wakens  in  the  night  to  find  he  has 
elaborated  some  new  and  beautfiul  idea.  We 
may  not  all  do  this,  but  we  are  badly  off  if  we 
cannot  go  to  sleep  with  some  large  and  inspir- 
ing thought,  some  tender  or  loving  feeling 
which  shall  live  on  through  the  hours  of  sleep, 
making  us  finer,  better  men  and  women,  more 
and  more  sensitive  to  the  beauty  and  signifi- 
cance of  life.  I  know  of  nothing  more  charm- 
ing in  literature  than  the  dream  trysts  of  Peter 
Ibbetson.  True  or  not,  they  are  symbolic 
of  what  may  happen  in  sleep  to  enrich  and 
develop  our  lives,  and  which  may  save  them 
from  the  dreariness  and  unhappiness  that 
must  so  often  persist  for  years. 

"Oh,  now  you  are  dreaming  true.  It's  quite 
easy  —  my  father  taught  me.  You  have  only 
to  sleep  with  your  feet  crossed  and  your  hands 
behind  your  head.   You  must  never  leave  off 


ii8  WAR-TIME  NERVES 

thinking  where  you  want  to  be  in  your  dreams, 
and  when  you  fall  asleep  you  will  get  there." 

But  those  who  lie  awake  must  not  wish  too 
much  for  sleep.  Sleep  will  always  elude  us  if 
we  seek  too  ardently.  The  wearying  devices 
which  are  recommended  will  usually  fail  to 
produce  sleep,  and  the  man  who  reads  until 
dawn  or  who  looks  anxiously  at  his  watch  every 
hour  is  sure  to  suffer  more  than  one  who  takes 
the  night  as  it  comes.  If  there  is  no  actual 
pain  it  should  be  possible  to  lie  awake  success- 
fully, which  is  almost  as  good  as  sleep. 

I  do  not  believe  that  the  mind  need  always 
be  active.  It  is  quite  possible  to  lie  for  hours 
almost  unthinking  and  so  virtually  sleeping. 
If  life  has  become  bearable,  if  the  tired  mind 
at  last  understands  why  it  is  living  —  that 
some  great  purpose  underlies  the  complexities 
and  distractions  of  the  day;  a  purpose  which 
reaches  back,  far  back  beyond  our  sight  and 
understanding,  into  the  heart  and  life  of  God; 
if  we  can  feel  that  our  living  is  not  in  vain,  that 
our  successes,  our  failures,  our  happiness,  and 


SLEEP  1 19 

our  sorrow,  are  all  known  and  understood  in 
some  way  far  beyond  our  ken,  there  will  be 
no  fear  of  the  night,  but  only  a  great  under- 
standing which  makes  it  almost  a  matter  of 
indifference  whether  we  wake  or  sleep. 


THE   END 


CAMBRIDGE  .  MASSACHUSETTS 
U    .    S    .    A 


CENTRAL  UNIVERSITY  LIBRARY 

University  of  California,  San  Diego 


DATE  DUE 


UANiiUl990 


a  39 


UCSD  Libr. 


UC  SOUTHERN  REGIONAL  LIBRARY  FACILITY 


AA    001  215  667   5 


